Effects of glucagon like peptide-1 to mediate glycemic effects of weight loss surgery

Marzieh Salehi, David A. D'Alessio

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

To date, weight loss surgeries are the most effective treatment for obesity and glycemic control in patients with type 2 diabetes. Roux-en-Y gastric bypass surgery (RYGB) and sleeve gastrectomy (SG), two widely used bariatric procedures for the treatment of obesity, induce diabetes remission independent of weight loss while glucose improvement after adjustable gastric banding (AGB) is proportional to the amount of weight loss. The immediate, weight-loss independent glycemic effect of gastric bypass has been attributed to postprandial hyperinsulinemia and an enhanced incretin effect. The rapid passage of nutrients into the intestine likely accounts for significantly enhanced glucagon like-peptide 1 (GLP-1) secretion, and postprandial hyperinsulinemia after GB is typically attributed to the combined effects of elevated glucose and GLP-1. For this review we focus on the beneficial effects of the three most commonly performed bariatric procedures, RYGB, SG, and AGB, on glucose metabolism and diabetes remission. Central to this discussion will be the extent to which the effects of surgery are mediated by GLP-1. Better understanding of these mechanisms could provide insight to development of novel therapeutic strategies for treatment of diabetes as well as refinement of surgical techniques.

Original languageEnglish (US)
Pages (from-to)171-179
Number of pages9
JournalReviews in Endocrine and Metabolic Disorders
Volume15
Issue number3
DOIs
StatePublished - Sep 2014
Externally publishedYes

Keywords

  • Diabetes
  • GLP-1
  • Gastric bypass surgery
  • Hyperinsulinemia
  • Hypoglycemia
  • Sleeve gastrectomy

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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