Magnitude and variability of the glucagon-like peptide-1 response in patients with type 2 diabetes up to 2 years following gastric bypass surgery

Diabetes Care. 2012 Jan;35(1):42-6. doi: 10.2337/dc11-1472. Epub 2011 Nov 28.

Abstract

Objective: To characterize the magnitude and variance of the change of glucose and glucagon-like peptide-1 (GLP-1) concentrations, and to identify determinants of glucose control up to 2 years after gastric bypass (GBP).

Research design and methods: Glucose and GLP-1 concentrations were measured during an oral glucose challenge before and 1, 12, and 24 months after GBP in 15 severely obese patients with type 2 diabetes.

Results: Glucose area under the curve from 0 to 180 min (AUC(0-180)) started decreasing in magnitude (P < 0.05) 1 month after surgery. GLP-1 AUC(0-180) increased in magnitude 1 month after GBP (P < 0.05), with increased variance only after 1 year (P(σ)(2) ≤ 0.001). GLP-1 AUC(0-180) was positively associated with insulin AUC(0-180) (P = 0.025).

Conclusions: The increase in variance of GLP-1 at 1 and 2 years after GBP suggests mechanisms other than proximal gut bypass to explain the enhancement of GLP-1 secretion. The association between GLP-1 and insulin concentrations supports the idea that the incretins are involved in glucose control after GBP.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Area Under Curve
  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetes Mellitus, Type 2 / surgery*
  • Female
  • Follow-Up Studies
  • Gastric Bypass*
  • Glucagon-Like Peptide 1 / metabolism*
  • Glucose Tolerance Test
  • Humans
  • Incretins
  • Male
  • Middle Aged
  • Obesity / physiopathology*
  • Obesity / surgery*

Substances

  • Blood Glucose
  • Incretins
  • Glucagon-Like Peptide 1