Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass

Publikation: Bidrag til tidsskriftLetterForskningfagfællebedømt

Standard

Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass. / Svane, M S; Toft-Nielsen, M B; Kristiansen, V B; Hartmann, B; Holst, J J; Madsbad, S; Bojsen-Møller, K N.

I: Diabetic Medicine Online, Bind 34, Nr. 12, 12.2017, s. 1783-1787.

Publikation: Bidrag til tidsskriftLetterForskningfagfællebedømt

Harvard

Svane, MS, Toft-Nielsen, MB, Kristiansen, VB, Hartmann, B, Holst, JJ, Madsbad, S & Bojsen-Møller, KN 2017, 'Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass', Diabetic Medicine Online, bind 34, nr. 12, s. 1783-1787. https://doi.org/10.1111/dme.13443

APA

Svane, M. S., Toft-Nielsen, M. B., Kristiansen, V. B., Hartmann, B., Holst, J. J., Madsbad, S., & Bojsen-Møller, K. N. (2017). Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass. Diabetic Medicine Online, 34(12), 1783-1787. https://doi.org/10.1111/dme.13443

Vancouver

Svane MS, Toft-Nielsen MB, Kristiansen VB, Hartmann B, Holst JJ, Madsbad S o.a. Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass. Diabetic Medicine Online. 2017 dec;34(12):1783-1787. https://doi.org/10.1111/dme.13443

Author

Svane, M S ; Toft-Nielsen, M B ; Kristiansen, V B ; Hartmann, B ; Holst, J J ; Madsbad, S ; Bojsen-Møller, K N. / Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass. I: Diabetic Medicine Online. 2017 ; Bind 34, Nr. 12. s. 1783-1787.

Bibtex

@article{a144e8cd582e4c01ba0ea6f7198f5462,
title = "Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass",
abstract = "BACKGROUND: Roux-en-Y gastric bypass is associated with an increased risk of postprandial hyperinsulinaemic hypoglycaemia, but the underlying pathophysiology remains poorly understood. We therefore examined the effect of re-routing of nutrient delivery on gut-islet cell crosstalk in a person with severe postprandial hypoglycaemia after Roux-en-Y gastric bypass.CASE REPORT: A person with severe postprandial hypoglycaemia, who underwent surgical reversal of Roux-en-Y gastric bypass, was studied before reversal and at 2 weeks and 3 months after reversal surgery using liquid mixed meal tests and hyperinsulinaemic-euglycaemic clamps. The nadir of postprandial plasma glucose rose from 2.8 mmol/l to 4.1 mmol/l at 2 weeks and to 4.4 mmol/l at 3 months after reversal. Concomitant insulin- and glucagon-like peptide-1 secretion (peak concentrations and area under the curve) clearly decreased after reversal, while concentrations of glucose-dependent insulinotropic polypeptide and ghrelin increased. Insulin clearance declined after reversal, whereas clamp-estimated peripheral insulin sensitivity was unchanged. The person remained without symptoms of hypoglycaemia, but had experienced significant weight gain at 15- month follow-up.DISCUSSION: Accelerated nutrient absorption may be a driving force behind postprandial hyperinsulinaemic hypoglycaemia after Roux-en-Y gastric bypass. Re-routing of nutrients by reversal of the Roux-en-Y gastric bypass diminished postprandial plasma glucose excursions, alleviated postprandial insulin and glucagon-like peptide-1 hypersecretion and eliminated postprandial hypoglycaemia, which emphasizes the importance of altered gut-islet cell crosstalk for glucose metabolism after Roux-en-Y gastric bypass. This article is protected by copyright. All rights reserved.",
keywords = "Case Reports",
author = "Svane, {M S} and Toft-Nielsen, {M B} and Kristiansen, {V B} and B Hartmann and Holst, {J J} and S Madsbad and Bojsen-M{\o}ller, {K N}",
note = "This article is protected by copyright. All rights reserved.",
year = "2017",
month = "12",
doi = "10.1111/dme.13443",
language = "English",
volume = "34",
pages = "1783--1787",
journal = "Diabetic Medicine Online",
issn = "1464-5491",
publisher = "Wiley-Blackwell",
number = "12",

}

RIS

TY - JOUR

T1 - Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass

AU - Svane, M S

AU - Toft-Nielsen, M B

AU - Kristiansen, V B

AU - Hartmann, B

AU - Holst, J J

AU - Madsbad, S

AU - Bojsen-Møller, K N

N1 - This article is protected by copyright. All rights reserved.

PY - 2017/12

Y1 - 2017/12

N2 - BACKGROUND: Roux-en-Y gastric bypass is associated with an increased risk of postprandial hyperinsulinaemic hypoglycaemia, but the underlying pathophysiology remains poorly understood. We therefore examined the effect of re-routing of nutrient delivery on gut-islet cell crosstalk in a person with severe postprandial hypoglycaemia after Roux-en-Y gastric bypass.CASE REPORT: A person with severe postprandial hypoglycaemia, who underwent surgical reversal of Roux-en-Y gastric bypass, was studied before reversal and at 2 weeks and 3 months after reversal surgery using liquid mixed meal tests and hyperinsulinaemic-euglycaemic clamps. The nadir of postprandial plasma glucose rose from 2.8 mmol/l to 4.1 mmol/l at 2 weeks and to 4.4 mmol/l at 3 months after reversal. Concomitant insulin- and glucagon-like peptide-1 secretion (peak concentrations and area under the curve) clearly decreased after reversal, while concentrations of glucose-dependent insulinotropic polypeptide and ghrelin increased. Insulin clearance declined after reversal, whereas clamp-estimated peripheral insulin sensitivity was unchanged. The person remained without symptoms of hypoglycaemia, but had experienced significant weight gain at 15- month follow-up.DISCUSSION: Accelerated nutrient absorption may be a driving force behind postprandial hyperinsulinaemic hypoglycaemia after Roux-en-Y gastric bypass. Re-routing of nutrients by reversal of the Roux-en-Y gastric bypass diminished postprandial plasma glucose excursions, alleviated postprandial insulin and glucagon-like peptide-1 hypersecretion and eliminated postprandial hypoglycaemia, which emphasizes the importance of altered gut-islet cell crosstalk for glucose metabolism after Roux-en-Y gastric bypass. This article is protected by copyright. All rights reserved.

AB - BACKGROUND: Roux-en-Y gastric bypass is associated with an increased risk of postprandial hyperinsulinaemic hypoglycaemia, but the underlying pathophysiology remains poorly understood. We therefore examined the effect of re-routing of nutrient delivery on gut-islet cell crosstalk in a person with severe postprandial hypoglycaemia after Roux-en-Y gastric bypass.CASE REPORT: A person with severe postprandial hypoglycaemia, who underwent surgical reversal of Roux-en-Y gastric bypass, was studied before reversal and at 2 weeks and 3 months after reversal surgery using liquid mixed meal tests and hyperinsulinaemic-euglycaemic clamps. The nadir of postprandial plasma glucose rose from 2.8 mmol/l to 4.1 mmol/l at 2 weeks and to 4.4 mmol/l at 3 months after reversal. Concomitant insulin- and glucagon-like peptide-1 secretion (peak concentrations and area under the curve) clearly decreased after reversal, while concentrations of glucose-dependent insulinotropic polypeptide and ghrelin increased. Insulin clearance declined after reversal, whereas clamp-estimated peripheral insulin sensitivity was unchanged. The person remained without symptoms of hypoglycaemia, but had experienced significant weight gain at 15- month follow-up.DISCUSSION: Accelerated nutrient absorption may be a driving force behind postprandial hyperinsulinaemic hypoglycaemia after Roux-en-Y gastric bypass. Re-routing of nutrients by reversal of the Roux-en-Y gastric bypass diminished postprandial plasma glucose excursions, alleviated postprandial insulin and glucagon-like peptide-1 hypersecretion and eliminated postprandial hypoglycaemia, which emphasizes the importance of altered gut-islet cell crosstalk for glucose metabolism after Roux-en-Y gastric bypass. This article is protected by copyright. All rights reserved.

KW - Case Reports

U2 - 10.1111/dme.13443

DO - 10.1111/dme.13443

M3 - Letter

C2 - 28782840

VL - 34

SP - 1783

EP - 1787

JO - Diabetic Medicine Online

JF - Diabetic Medicine Online

SN - 1464-5491

IS - 12

ER -

ID: 182619812