beta-Cell Function Improvements in Grade I/II Obese Subjects With Type 2 Diabetes 1 Month After Biliopancreatic Diversion Results from modeling analyses of oral glucose tolerance tests and hyperglycemic clamp studies

Autor(es)

Junqueira Vasques, Ana Carolina ^[1] ; Pareja, Jose Carlos ^{[1, 2]} ; de Oliveira, Maria da Saude ^[1] ; Novaes, Fernanda Satake ^[1] ; de Oliveira Lima, Marcelo Miranda ^[1] ; Chaim, Elinton A. ^[2] ; Piccinini, Francesca ^[3] ; Dalla Man, Chiara ^[3] ; Cobelli, Claudio ^[3] ; Geloneze, Bruno ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Gastroctr, Lab Invest Metab & Diabet, Sao Paulo - Brazil

^[2] Univ Estadual Campinas, Dept Surg, Diabet Surg Unit, Sao Paulo - Brazil

^[3] Univ Padua, Dept Informat Engn, Padua - Italy

• Tipo de documento: Artigo Científico
• Fonte: DIABETES CARE; v. 36, n. 12, p. 4117-4124, DEC 2013.
• Citações Web of Science: 6

Resumo

OBJECTIVETo investigate the effect of biliopancreatic diversion (BPD) surgery on -cell function in grade I and II obese patients with type 2 diabetes using oral and intravenous glucose loads.RESEARCH DESIGN AND METHODSSixty-eight women were divided into the following three groups: 19 lean-control (23.0 2.2 kg/m(2)) and 18 obese-control (35.0 4.8 kg/m(2)) subjects with normal glucose tolerance, and 31 obese patients with type 2 diabetes (36.3 +/- 3.7 kg/m(2)). Of the 31 diabetic women, 64% underwent BPD (n = 20, BMI: 36.5 +/- 3.7 kg/m(2)) and were reassessed 1 month after surgery. Oral glucose tolerance tests and hyperglycemic clamps were performed. Mathematical modeling was used to analyze basal and stimulated -cell function, insulin sensitivity (IS), hepatic extraction (HE) of insulin, and delay time of -cell response to a specific plasma glucose concentration.RESULTSAfter BPD, restoration of the basal disposition index (P < 0.001) and improvement of the stimulated disposition indices in oral and intravenous glucose stimulation of the -cell were observed (P < 0.05). In both dynamic tests, there were no changes in the delay time of -cell response. IS for oral glucose stimulation (ISoral) and intravenous clamp glucose stimulation (ISclamp) was completely normalized (P < 0.001). ISoral and ISclamp increased approximately 5.0-fold and 3.5-fold, respectively (P < 0.01). The HE of insulin increased in the basal (P < 0.05) and stimulated states (P < 0.01).CONCLUSIONS-Cell function, IS, and HE of insulin improved after BPD, which improved glycemic control. (AU)

• Processo FAPESP: 08/09451-7 - Capacidade secretória de insulina em pacientes saudáveis, em obesos, em obesos diabéticos tipo 2 e em obesos diabéticos tipo 2 submetidos à cirurgia bariátrica através do clamp hiperglicêmico.
• Beneficiário: Bruno Geloneze Neto
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 08/07312-0 - Capacidade secretória de insulina em pacientes saudáveis, em obesos, em obesos diabéticos tipo 2 e em obesos diabéticos tipo 2 submetidos à cirurgia bariátrica através do clamp hiperglicêmico
• Beneficiário: Ana Carolina Junqueira Vasques
• Modalidade de apoio: Bolsas no Brasil - Doutorado