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- Title
Postprandial diabetic glucose tolerance is normalized by gastric bypass feeding as opposed to gastric feeding and is associated with exaggerated GLP-1 secretion: a case report.
- Authors
Dirksen C; Hansen DL; Madsbad S; Hvolris LE; Naver LS; Holst JJ; Worm D; Dirksen, Carsten; Hansen, Dorte L; Madsbad, Sten; Hvolris, Lisbeth E; Naver, Lars S; Holst, Jens J; Worm, Dorte
- Abstract
<bold>Objective: </bold>To examine after gastric bypass the effect of peroral versus gastroduodenal feeding on glucose metabolism.<bold>Research Design and Methods: </bold>A type 2 diabetic patient was examined on 2 consecutive days 5 weeks after gastric bypass. A standard liquid meal was given on the first day into the bypassed gastric remnant and on the second day perorally. Plasma glucose, insulin, C-peptide, glucagon, incretin hormones, peptide YY, and free fatty acids were measured.<bold>Results: </bold>Peroral feeding reduced 2-h postprandial plasma glucose (7.8 vs. 11.1 mmol/l) and incremental area under the glucose curve (iAUC) (0.33 vs. 0.49 mmol . l(-1) . min(-1)) compared with gastroduodenal feeding. beta-Cell function (iAUC(Cpeptide/Glu)) was more than twofold improved during peroral feeding, and the glucagon-like peptide (GLP)-1 response increased nearly fivefold.<bold>Conclusions: </bold>Improvement in postprandial glucose metabolism after gastric bypass is an immediate and direct consequence of the gastrointestinal rearrangement, associated with exaggerated GLP-1 release and independent of changes in insulin sensitivity, weight loss, and caloric restriction.
- Publication
Diabetes Care, 2010, Vol 33, Issue 2, p375
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/dc09-1374