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
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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. / Dirksen, Carsten; Hansen, Dorte L; Madsbad, Sten; Hvolris, Lisbeth E; Naver, Lars S; Holst, Jens Juul; Worm, Dorte.
I: Diabetes Care, Bind 33, Nr. 2, 2010, s. 375-377.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Postprandial diabetic glucose tolerance is normalized by gastric bypass feeding as opposed to gastric feeding and is associated with exaggerated GLP-1 secretion
T2 - a case report
AU - Dirksen, Carsten
AU - Hansen, Dorte L
AU - Madsbad, Sten
AU - Hvolris, Lisbeth E
AU - Naver, Lars S
AU - Holst, Jens Juul
AU - Worm, Dorte
N1 - Keywords: Area Under Curve; Blood Glucose; C-Peptide; Diabetes Mellitus, Type 2; Enteral Nutrition; Fatty Acids, Nonesterified; Gastric Bypass; Glucagon; Glucagon-Like Peptide 1; Humans; Incretins; Male; Middle Aged; Obesity, Morbid; Peptide YY; Postoperative Period; Postprandial Period
PY - 2010
Y1 - 2010
N2 - OBJECTIVE: To examine after gastric bypass the effect of peroral versus gastroduodenal feeding on glucose metabolism.RESEARCH DESIGN AND METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.
AB - OBJECTIVE: To examine after gastric bypass the effect of peroral versus gastroduodenal feeding on glucose metabolism.RESEARCH DESIGN AND METHODS: 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.RESULTS: 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.CONCLUSIONS: 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.
KW - Area Under Curve
KW - Blood Glucose
KW - C-Peptide
KW - Diabetes Mellitus, Type 2
KW - Enteral Nutrition
KW - Fatty Acids, Nonesterified
KW - Gastric Bypass
KW - Glucagon
KW - Glucagon-Like Peptide 1
KW - Humans
KW - Incretins
KW - Male
KW - Middle Aged
KW - Obesity, Morbid
KW - Peptide YY
KW - Postoperative Period
KW - Postprandial Period
U2 - 10.2337/dc09-1374
DO - 10.2337/dc09-1374
M3 - Journal article
C2 - 19918005
VL - 33
SP - 375
EP - 377
JO - Diabetes Care
JF - Diabetes Care
SN - 0149-5992
IS - 2
ER -
ID: 18700346