Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;35(1):42-6.
doi: 10.2337/dc11-1472. Epub 2011 Nov 28.

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

Bart J Van der Schueren  1 , Peter Homel, Mariam Alam, Keesandra Agenor, Gary Wang, David Reilly, Blandine Laferrère
Affiliations

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

Bart J Van der Schueren et al. Diabetes Care. 2012 Jan.

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A: Variables for which variance decreased over time after GBP. Left: Mean ± SD for glucose AUC0–180, HOMA-B, and HOMA-IR. Right: Variance of glucose AUC0–180, HOMA-B, and HOMA-IR. B: Variables for which variance tends to decrease over time after GBP. Left: Mean ± SD for weight and incretin effect on insulin. Right: Variance of weight and incretin effect on insulin. C: Variables for which variance increased over time after GBP. Left: Mean ± SD for GLP-1 AUC0–180 and insulin AUC0–30. Right: Variance for GLP-1 AUC0–180 and insulin AUC0–30. D: Variables for which variance did not change after GBP. Left: Mean ± SD for insulin AUC0–180 and ISI composite. Right: Variance of and ISI composite insulin AUC0–180. *P < 0.05 vs. baseline, ‡P < 0.05 vs. 1 month, $P < 0.05 vs. 1 year. N = 15 (except for incretin effect, n = 14).
Figure 1
Figure 1
A: Variables for which variance decreased over time after GBP. Left: Mean ± SD for glucose AUC0–180, HOMA-B, and HOMA-IR. Right: Variance of glucose AUC0–180, HOMA-B, and HOMA-IR. B: Variables for which variance tends to decrease over time after GBP. Left: Mean ± SD for weight and incretin effect on insulin. Right: Variance of weight and incretin effect on insulin. C: Variables for which variance increased over time after GBP. Left: Mean ± SD for GLP-1 AUC0–180 and insulin AUC0–30. Right: Variance for GLP-1 AUC0–180 and insulin AUC0–30. D: Variables for which variance did not change after GBP. Left: Mean ± SD for insulin AUC0–180 and ISI composite. Right: Variance of and ISI composite insulin AUC0–180. *P < 0.05 vs. baseline, ‡P < 0.05 vs. 1 month, $P < 0.05 vs. 1 year. N = 15 (except for incretin effect, n = 14).
Figure 1
Figure 1
A: Variables for which variance decreased over time after GBP. Left: Mean ± SD for glucose AUC0–180, HOMA-B, and HOMA-IR. Right: Variance of glucose AUC0–180, HOMA-B, and HOMA-IR. B: Variables for which variance tends to decrease over time after GBP. Left: Mean ± SD for weight and incretin effect on insulin. Right: Variance of weight and incretin effect on insulin. C: Variables for which variance increased over time after GBP. Left: Mean ± SD for GLP-1 AUC0–180 and insulin AUC0–30. Right: Variance for GLP-1 AUC0–180 and insulin AUC0–30. D: Variables for which variance did not change after GBP. Left: Mean ± SD for insulin AUC0–180 and ISI composite. Right: Variance of and ISI composite insulin AUC0–180. *P < 0.05 vs. baseline, ‡P < 0.05 vs. 1 month, $P < 0.05 vs. 1 year. N = 15 (except for incretin effect, n = 14).
Figure 1
Figure 1
A: Variables for which variance decreased over time after GBP. Left: Mean ± SD for glucose AUC0–180, HOMA-B, and HOMA-IR. Right: Variance of glucose AUC0–180, HOMA-B, and HOMA-IR. B: Variables for which variance tends to decrease over time after GBP. Left: Mean ± SD for weight and incretin effect on insulin. Right: Variance of weight and incretin effect on insulin. C: Variables for which variance increased over time after GBP. Left: Mean ± SD for GLP-1 AUC0–180 and insulin AUC0–30. Right: Variance for GLP-1 AUC0–180 and insulin AUC0–30. D: Variables for which variance did not change after GBP. Left: Mean ± SD for insulin AUC0–180 and ISI composite. Right: Variance of and ISI composite insulin AUC0–180. *P < 0.05 vs. baseline, ‡P < 0.05 vs. 1 month, $P < 0.05 vs. 1 year. N = 15 (except for incretin effect, n = 14).
See this image and copyright information in PMC

References

    1. Bose M, Teixeira J, Oliván B, et al. Weight loss and incretin responsiveness improve glucose control independently after gastric bypass surgery. J Diabetes 2010;2:47–5510.1111/j.1753-0407.2009.00064.x - DOI - PMC - PubMed
    1. Laferrère B, Teixeira J, McGinty J, et al. Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes. J Clin Endocrinol Metab 2008;93:2479–248510.1210/jc.2007-2851 - DOI - PMC - PubMed
    1. Falkén Y, Hellström PM, Holst JJ, Näslund E. Changes in glucose homeostasis after Roux-en-Y gastric bypass surgery for obesity at day three, two months, and one year after surgery: role of gut peptides. J Clin Endocrinol Metab 2011;96:2227–223510.1210/jc.2010-2876 - DOI - PubMed
    1. DiGiorgi M, Rosen DJ, Choi JJ, et al. Re-emergence of diabetes after gastric bypass in patients with mid- to long-term follow-up. Surg Obes Relat Dis 2010;6:249–25310.1016/j.soard.2009.09.019 - DOI - PubMed
    1. Chikunguwo SM, Wolfe LG, Dodson P, et al. Analysis of factors associated with durable remission of diabetes after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2010;6:254–25910.1016/j.soard.2009.11.003 - DOI - PubMed

Publication types