Role of vagal activation in postprandial glucose metabolism after gastric bypass in individuals with and without hypoglycaemia

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

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Patients who have undergone gastric bypass surgery (GB) have enhanced postprandial hyperinsulinaemia and a greater incretin effect is apparent. In the present study, we sought to determine the effect of vagal activation, a neural component of the enteroinsular axis, on postprandial glucose metabolism in patients with and without hypoglycaemia after GB. Seven patients with documented post-GB hypoglycaemia, seven asymptomatic patients without hypoglycaemia post-GB, and 10 weight-matched non-surgical controls with normal glucose tolerance were recruited. Blood glucose, and islet hormone and incretin secretion were compared during mixed meal tolerance tests (MMTs) with and without prior sham-feeding on two separate days. Sham feeding preceding the MMT caused a more rapid increase in prandial blood glucose levels but lowered overall glycaemia in all three groups (P < 0.05). Sham feeding had a similar effect to increase early (P < 0.05), but not overall, meal-induced insulin secretion in the three groups. Prandial glucagon concentrations were significantly greater in the GB groups, and sham feeding accentuated this response (P < 0.05). The effect of vagal activation on prandial glucose and islet-cell function is preserved in patients who have undergone GB, in those both with and without hypoglycaemia.

Original languageEnglish (US)
Pages (from-to)1513-1517
Number of pages5
JournalDiabetes, Obesity and Metabolism
Volume21
Issue number6
DOIs
StatePublished - Jun 2019

Keywords

  • bariatric surgery
  • hypoglycaemia
  • incretin physiology
  • β-cell function

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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