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Effect of Laparoscopic Sleeve Gastrectomy on Static and Dynamic Measures of Glucose Homeostasis and Incretin Hormone Response 4-Years Post-Operatively / Thinzar Min; Sarah L. Prior; Rachel Churm; Gareth Dunseath; Jonathan D. Barry; Jeffrey W. Stephens

Obesity Surgery, Pages: 1 - 10

Swansea University Author: Min, Thinzar

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Abstract

Introduction: There is limited literature available on the long-term effect of bariatric surgery especially laparoscopic sleeve gastrectomy (LSG) on the incretin hormone response. Aim: Our primary aim was to investigate changes in glucose metabolism and incretin hormone responses in participants wit...

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Published in: Obesity Surgery
ISSN: 0960-8923 1708-0428
Published: 2019
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa51277
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Abstract: Introduction: There is limited literature available on the long-term effect of bariatric surgery especially laparoscopic sleeve gastrectomy (LSG) on the incretin hormone response. Aim: Our primary aim was to investigate changes in glucose metabolism and incretin hormone responses in participants with impaired glucose regulation approximately 4 years after LSG. The secondary aim was to examine the long-term incretin hormone changes of biliopancreatic diversion (BPD). Method: A non-randomized prospective study comprising of 10 participants undergoing LSG and 6 participants undergoing BPD. Serial measurements of glucose, insulin, C-peptide, glucagon like peptide -1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were performed during an oral glucose tolerance test pre-operatively and 1 month, 6 months and at approximately 4-7 years post-operatively. Area under the curve (AUC) were examined at 60 and 120 minutes.Results: In the LSG group, a significant reduction in 2-hr plasma glucose (2hr PG), HbA1c, and HOMA-IR was observed at 4 years. Compared with pre-operative levels, significant increases in post-glucose GLP-1 secretion were observed at 1 and 6 months, but not maintained at 4 years. A linear increase was seen in post-glucose GIP response at 1-month and 6-months and 4-years. Within the BPD group, a reduction in HbA1c along with an increase GLP-1 response was observed at 7 years. Conclusion: An increase in GLP-1 response was not preserved at 4 years, but a significant increase in GIP response was observed along with improved glycaemic control following LSG.
Keywords: Bariatric surgery, sleeve gastrectomy, incretin hormone changes, diabetes
College: Swansea University Medical School
Start Page: 1
End Page: 10