Recovery of the Incretin Effect in Type 2 Diabetic Patients After Biliopancreatic Diversion

Autor(es)

Novaes, Fernanda S. ^[1] ; Vasques, Ana C. J. ^{[1, 2]} ; Pareja, Jose C. ^{[1, 3]} ; Knop, Filip K. ^[4] ; Tura, Andrea ^[5] ; Chaim, Elinton A. ^[3] ; Geloneze, Bruno ^[1]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Diabet Surg Unit, Lab Invest Metab & Diabet, BR-13081970 Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Diabet Surg Unit, Gastroctr, Sch Appl Sci, BR-13081970 Campinas, SP - Brazil

^[3] Univ Estadual Campinas, Diabet Surg Unit, Dept Surg, BR-13081970 Campinas, SP - Brazil

^[4] Univ Copenhagen, Gentofte Hosp, Dept Med, Ctr Diabet Res, DK-2100 Hellerup - Denmark

^[5] Italian Natl Res Council, Inst Biomed Engn, I-35127 Padua - Italy

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM; v. 100, n. 5, p. 1984-1988, MAY 2015.
• Citações Web of Science: 6

Resumo

Context: Bariatric surgery often results in remission of the diabetic state in obese patients. Increased incretin effect seems to play an important role in the glycemic improvements after Rouxen-Y gastric bypass, but the impact of biliopancreatic diversion (BPD) remains unexplored. Objective: The objective was to elucidate the effect of BPD on the incretin effect and its interplay with beta-cell function and insulin sensitivity (IS) in obese subjects with type 2 diabetes (T2DM). Design, Setting and Patients: Twenty-three women were studied: a control group of 13 lean, normal glucose-tolerant women (lean NGT) studied once and 10 obese patients with T2DM studied before, 1 and 12 months after BPD. Intervention: The ObeseT2DM group underwent BPD. Main Outcome Measures: The main outcome measure was the change in incretin effect as measured by the isoglycemic intravenous glucose infusion test. Secondary outcomes encompassed IS and beta-cell function. Results: At baseline, the incretin effect was lower in obese T2DM compared to lean NGT (P < .05). One month after BPD, the incretin effect was not changed, but at 12 months it reached the level of the lean NGT group (P < .05). IS improved (P < .05) 1 month after BPD and at 12 months it resembled the levels of the lean NGT group. Insulin secretory rate and beta-cell glucose sensitivity increased after BPD and achieved levels similar to lean NGT group 1 month after BPD and even higher levels at 12 months (P < .05). Conclusions: BPD has no acute impact on the reduced incretin effect, but 12 months after surgery the incretin effect normalizes alongside normalization of glucose control, IS and beta-cell function. (AU)

• 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