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Short- and Long-Term Hormonal and Metabolic Consequences of Reversing Gastric Bypass to Normal Anatomy in a Type 2 Diabetes Patient.

Author:
  • Nils Wierup
  • Andreas Lindqvist
  • Peter Spégel
  • Leif Groop
  • Jan Hedenbro
  • Mikael Ekelund
Publishing year: 2015
Language: English
Pages: 180-185
Publication/Series: Obesity Surgery
Volume: 25
Issue: 1
Document type: Journal article
Publisher: Springer

Abstract english

Gastric bypass (GBP) results in rapid type 2 diabetes (T2D) remission in most cases. Consequences of GBP reversal are unknown. A GBP-operated T2D patient was given mixed-meal tests before (MMTpre), 2 months (MMT2-M) and 12 months (MMT12-M) after GBP reversal. Glucose, hormones and metabolite profiles were assessed. MMT2-M displayed slightly lower glucose levels; MMT12-M displayed higher glucose and insulin levels, indicating deteriorating glycaemia. Homeostasis model assessment (HOMA)-β was higher at MMT2-M, but reduced at MMT12-M. Matsuda index revealed slightly reduced insulin sensitivity at MMT2-M, which deteriorated further at MMT12-M. Markers for metabolic stress and insulin resistance were elevated at MMT12-M. Gastric inhibitory polypeptide (GIP) levels were increased at MMT2-M and decreased at MMT12-M. Glucagon-like peptide-1 (GLP-1) decreased at MMT2-M and further decreased at MMT12-M. In conclusion, in this patient, GBP reversal provoked deteriorating glycaemia and long-term development of insulin resistance.

Keywords

  • Surgery

Other

Published
  • Neuroendocrine Cell Biology
  • Molecular Metabolism
  • Diabetes and Endocrinology
  • ISSN: 1708-0428
Peter Spegel
E-mail: peter [dot] spegel [at] chem [dot] lu [dot] se

Researcher

Centre for Analysis and Synthesis

1

Lund University Diabetes Centre, CRC, SUS Malmö, Entrance 72, House 91:12. SE-205 02 Malmö. Telephone: +46 40 39 10 00