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Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy

A Mallipedhi, Sarah Prior Orcid Logo, Jonathan Barry, Scott Caplin, John Baxter, Jeffrey Stephens Orcid Logo

Surgery for Obesity and Related Diseases, Volume: 10, Issue: 5, Pages: 860 - 869

Swansea University Authors: Sarah Prior Orcid Logo, Jeffrey Stephens Orcid Logo

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DOI (Published version): 10.1016/j.soard.2014.02.038

Abstract

BackgroundBariatric surgery is an effective treatment for morbid obesity. Current literature reports significant improvements in glucose homeostasis after malabsorptive surgery. There is limited evidence on the effects of laparoscopic sleeve gastrectomy (SG) on glucose-insulin homeostasis and postop...

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Published in: Surgery for Obesity and Related Diseases
Published: 2014
URI: https://cronfa.swan.ac.uk/Record/cronfa19722
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2019-09-18T13:36:41.8840915</datestamp><bib-version>v2</bib-version><id>19722</id><entry>2014-12-05</entry><title>Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy</title><swanseaauthors><author><sid>cdda101035997acfaa6fdf17097f52b2</sid><ORCID>0000-0001-8703-8092</ORCID><firstname>Sarah</firstname><surname>Prior</surname><name>Sarah Prior</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>5219d126f97f8f884bdb622099bd41de</sid><ORCID>0000-0003-2228-086X</ORCID><firstname>Jeffrey</firstname><surname>Stephens</surname><name>Jeffrey Stephens</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2014-12-05</date><deptcode>BMS</deptcode><abstract>BackgroundBariatric surgery is an effective treatment for morbid obesity. Current literature reports significant improvements in glucose homeostasis after malabsorptive surgery. There is limited evidence on the effects of laparoscopic sleeve gastrectomy (SG) on glucose-insulin homeostasis and postoperative incretin hormone response. The objective of this study was to examine the metabolic effects of SG on temporal changes in insulin and glucose homeostasis, incretin hormones and hepatic insulin clearance in patients with impaired glucose tolerance (IGT) and type 2 diabetes (T2 DM).MethodsA nonrandomized prospective study comprising 22 participants undergoing SG (body mass index [BMI] 50.1 kg/m2, glycated hemoglobin [HbA1c] 53 mmol/mol) and 15 participants undergoing biliopancreatic diversion (BPD) (BMI 62.1 kg/m2, HbA1c 58 mmol/mol). Serial measurements of glucose, insulin, C-peptide, glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic hormone (GIP) were performed during oral glucose tolerance testing preoperatively and 1 and 6 months postoperatively. Areas under the curve (AUC) were examined at 30, 60, and 120 minutes.ResultsWithin the SG group, significant improvements were observed respectively at 1 and 6 months in glucose control (HbA1c: &#x2212;0.9%, &#x2212;1.3%), measures of insulin sensitivity (fasting insulin: &#x2212;4.8 mU/L, &#x2212;8.5 mU/L; fasting C-peptide: &#x2212;0.6 pmol/L, &#x2212;1.1 pmol/L; Homeostasis Model Assessment [HOMA-IR]: &#x2212;0.144, &#x2212;0.174; HOMA %S:+29.6,+92.4), hepatic insulin clearance (+0.07,+0.13) and postprandial GLP-1 response (AUC0-30 pmol h L&#x2212;1:+300,+331, AUC0-60:+300,+294, AUC0-120:+316,+295). These results were comparable to the BPD group.ConclusionsSG is associated with significant early improvements in insulin sensitivity and incretin hormone response and results in significant improvements in IGT/T2 DM.</abstract><type>Journal Article</type><journal>Surgery for Obesity and Related Diseases</journal><volume>10</volume><journalNumber>5</journalNumber><paginationStart>860</paginationStart><paginationEnd>869</paginationEnd><publisher/><keywords>Type 2 diabetes mellitus, Obesity, Sleeve gastrectomy, Biliopancreatic diversion</keywords><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2014</publishedYear><publishedDate>2014-12-31</publishedDate><doi>10.1016/j.soard.2014.02.038</doi><url/><notes></notes><college>COLLEGE NANME</college><department>Biomedical Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>BMS</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2019-09-18T13:36:41.8840915</lastEdited><Created>2014-12-05T14:22:02.7577507</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>A</firstname><surname>Mallipedhi</surname><order>1</order></author><author><firstname>Sarah</firstname><surname>Prior</surname><orcid>0000-0001-8703-8092</orcid><order>2</order></author><author><firstname>Jonathan</firstname><surname>Barry</surname><order>3</order></author><author><firstname>Scott</firstname><surname>Caplin</surname><order>4</order></author><author><firstname>John</firstname><surname>Baxter</surname><order>5</order></author><author><firstname>Jeffrey</firstname><surname>Stephens</surname><orcid>0000-0003-2228-086X</orcid><order>6</order></author></authors><documents/><OutputDurs/></rfc1807>
spelling 2019-09-18T13:36:41.8840915 v2 19722 2014-12-05 Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy cdda101035997acfaa6fdf17097f52b2 0000-0001-8703-8092 Sarah Prior Sarah Prior true false 5219d126f97f8f884bdb622099bd41de 0000-0003-2228-086X Jeffrey Stephens Jeffrey Stephens true false 2014-12-05 BMS BackgroundBariatric surgery is an effective treatment for morbid obesity. Current literature reports significant improvements in glucose homeostasis after malabsorptive surgery. There is limited evidence on the effects of laparoscopic sleeve gastrectomy (SG) on glucose-insulin homeostasis and postoperative incretin hormone response. The objective of this study was to examine the metabolic effects of SG on temporal changes in insulin and glucose homeostasis, incretin hormones and hepatic insulin clearance in patients with impaired glucose tolerance (IGT) and type 2 diabetes (T2 DM).MethodsA nonrandomized prospective study comprising 22 participants undergoing SG (body mass index [BMI] 50.1 kg/m2, glycated hemoglobin [HbA1c] 53 mmol/mol) and 15 participants undergoing biliopancreatic diversion (BPD) (BMI 62.1 kg/m2, HbA1c 58 mmol/mol). Serial measurements of glucose, insulin, C-peptide, glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic hormone (GIP) were performed during oral glucose tolerance testing preoperatively and 1 and 6 months postoperatively. Areas under the curve (AUC) were examined at 30, 60, and 120 minutes.ResultsWithin the SG group, significant improvements were observed respectively at 1 and 6 months in glucose control (HbA1c: −0.9%, −1.3%), measures of insulin sensitivity (fasting insulin: −4.8 mU/L, −8.5 mU/L; fasting C-peptide: −0.6 pmol/L, −1.1 pmol/L; Homeostasis Model Assessment [HOMA-IR]: −0.144, −0.174; HOMA %S:+29.6,+92.4), hepatic insulin clearance (+0.07,+0.13) and postprandial GLP-1 response (AUC0-30 pmol h L−1:+300,+331, AUC0-60:+300,+294, AUC0-120:+316,+295). These results were comparable to the BPD group.ConclusionsSG is associated with significant early improvements in insulin sensitivity and incretin hormone response and results in significant improvements in IGT/T2 DM. Journal Article Surgery for Obesity and Related Diseases 10 5 860 869 Type 2 diabetes mellitus, Obesity, Sleeve gastrectomy, Biliopancreatic diversion 31 12 2014 2014-12-31 10.1016/j.soard.2014.02.038 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University 2019-09-18T13:36:41.8840915 2014-12-05T14:22:02.7577507 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine A Mallipedhi 1 Sarah Prior 0000-0001-8703-8092 2 Jonathan Barry 3 Scott Caplin 4 John Baxter 5 Jeffrey Stephens 0000-0003-2228-086X 6
title Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy
spellingShingle Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy
Sarah Prior
Jeffrey Stephens
title_short Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy
title_full Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy
title_fullStr Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy
title_full_unstemmed Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy
title_sort Temporal changes in glucose homeostasis and incretin hormone response at 1 and 6 months after laparoscopic sleeve gastrectomy
author_id_str_mv cdda101035997acfaa6fdf17097f52b2
5219d126f97f8f884bdb622099bd41de
author_id_fullname_str_mv cdda101035997acfaa6fdf17097f52b2_***_Sarah Prior
5219d126f97f8f884bdb622099bd41de_***_Jeffrey Stephens
author Sarah Prior
Jeffrey Stephens
author2 A Mallipedhi
Sarah Prior
Jonathan Barry
Scott Caplin
John Baxter
Jeffrey Stephens
format Journal article
container_title Surgery for Obesity and Related Diseases
container_volume 10
container_issue 5
container_start_page 860
publishDate 2014
institution Swansea University
doi_str_mv 10.1016/j.soard.2014.02.038
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 0
active_str 0
description BackgroundBariatric surgery is an effective treatment for morbid obesity. Current literature reports significant improvements in glucose homeostasis after malabsorptive surgery. There is limited evidence on the effects of laparoscopic sleeve gastrectomy (SG) on glucose-insulin homeostasis and postoperative incretin hormone response. The objective of this study was to examine the metabolic effects of SG on temporal changes in insulin and glucose homeostasis, incretin hormones and hepatic insulin clearance in patients with impaired glucose tolerance (IGT) and type 2 diabetes (T2 DM).MethodsA nonrandomized prospective study comprising 22 participants undergoing SG (body mass index [BMI] 50.1 kg/m2, glycated hemoglobin [HbA1c] 53 mmol/mol) and 15 participants undergoing biliopancreatic diversion (BPD) (BMI 62.1 kg/m2, HbA1c 58 mmol/mol). Serial measurements of glucose, insulin, C-peptide, glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic hormone (GIP) were performed during oral glucose tolerance testing preoperatively and 1 and 6 months postoperatively. Areas under the curve (AUC) were examined at 30, 60, and 120 minutes.ResultsWithin the SG group, significant improvements were observed respectively at 1 and 6 months in glucose control (HbA1c: −0.9%, −1.3%), measures of insulin sensitivity (fasting insulin: −4.8 mU/L, −8.5 mU/L; fasting C-peptide: −0.6 pmol/L, −1.1 pmol/L; Homeostasis Model Assessment [HOMA-IR]: −0.144, −0.174; HOMA %S:+29.6,+92.4), hepatic insulin clearance (+0.07,+0.13) and postprandial GLP-1 response (AUC0-30 pmol h L−1:+300,+331, AUC0-60:+300,+294, AUC0-120:+316,+295). These results were comparable to the BPD group.ConclusionsSG is associated with significant early improvements in insulin sensitivity and incretin hormone response and results in significant improvements in IGT/T2 DM.
published_date 2014-12-31T03:23:14Z
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