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- Title
Glucose-Stimulated Insulin Secretion in Gastric Bypass Patients with Hypoglycemic Syndrome: No Evidence for Inappropriate Pancreatic β-cell Function.
- Authors
Kim, Sun H.; Abbasi, Fahim; Lamendola, Cindy; Reaven, Gerald M.; McLaughlin, Tracey
- Abstract
Roux-en-Y gastric bypass surgery (RYGB) has been associated with a hypoglycemic syndrome characterized by postprandial hypoglycemia and hyperinsulinemia. The syndrome is believed to occur due to insulin hypersecretion from either pancreatic β-cell hyperplasia or hyperfunction. Eight RYGB patients with hypoglycemic syndrome had insulin secretion rates determined during a 240-min graded intravenous glucose infusion. They were compared to 34 nondiabetic, nonsurgical individuals who were divided based on their insulin sensitivity status as measured by the insulin suppression test: insulin-sensitive ( n = 8), insulin intermediate ( n = 7), and insulin-resistant ( n = 19). RYGB patients had insulin concentrations and HOMA-IR similar to the insulin-sensitive reference group. In addition, integrated insulin secretion rates were comparable to the insulin-sensitive group and significantly lower than the insulin intermediate ( p ≤ 0.046) and insulin-resistant groups ( p ≤ 0.001). Pancreatic β-cell sensitivity to glucose (slope relating glucose and ISR) was lowest in the RYGB group ( p ≤ 0.04). Patients with hypoglycemic syndrome post-RYGB do not have generalized hypersecretion of insulin and appear to have appropriate insulin secretion rate in response to intravenous glucose.
- Subjects
GASTRIC bypass; HYPOGLYCEMIA; PANCREATIC beta cells; HYPERPLASIA; INSULIN
- Publication
Obesity Surgery, 2010, Vol 20, Issue 8, p1110
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-010-0183-2