Beta-cell sensitivity to glucose is impaired after gastric bypass surgery

Marzieh Salehi, Amalia Gastaldelli, David A. D'Alessio

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Aims: Patients who have undergone Roux-en-Y gastric bypass surgery (GB) have exaggerated postprandial insulin secretion, which has been attributed to increased meal glucose appearance and enhanced incretin effect. Here, we sought to determine β-cell glucose sensitivity in the absence of meal stimulation and insulinotropic gut factors. Materials and methods: A total of 12 non-diabetic subjects with prior GB, and 7 matched non-surgical control subjects with normal glucose tolerance were studied. Blood glucose and insulin secretion rates were measured during a graded glucose infusion at increasing and then decreasing rates. Insulin sensitivity (SI) and glucose effectiveness (SG) were determined by the minimal model. Results: GB subjects had SI comparable to that of control subjects. GB subjects had relative hyperglycaemia during the highest dose of glucose infusion associated with significantly reduced β-cell glucose sensitivity throughout both step-up (GB: 34 ± 6, CN: 82 ± 9 pmol min−1 mM−1 L, P <.0001) and step-down (GB: 31 ± 6, CN: 74 ± 9 pmol min−1 mM−1 L, P <.0001) phases of the glucose infusion. GB subjects also had reduced SG (GB: 0.04 ± 0.00, CN: 0.07 ± 0.01 min−1, P =.004). Conclusion: In the absence of enteric stimuli, β-cell sensitivity to changes in glycaemia is blunted among individuals with GB, indicating a significant shift in a fundamental property of β-cell function several years after surgery.

Original languageEnglish (US)
Pages (from-to)872-878
Number of pages7
JournalDiabetes, Obesity and Metabolism
Volume20
Issue number4
DOIs
StatePublished - Apr 2018
Externally publishedYes

Keywords

  • gastric bypass surgery
  • glucose tolerance
  • β-cell glucose sensitivity

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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