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Comment
. 2021 Jun;70(6):1244-1246.
doi: 10.2337/dbi21-0022. Epub 2021 May 20.

Is Bariatric Surgery Brain Surgery?

Leticia E Sewaybricker  1 , Ellen A Schur  2
Affiliations
Comment

Is Bariatric Surgery Brain Surgery?

Leticia E Sewaybricker et al. Diabetes. 2021 Jun.
No abstract available

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Figures

Figure 1
Figure 1
Model describing the relationship between RYGB surgery, peripheral glucose concentration, and the CNS. A: RYGB surgery reconstructs gastrointestinal (GI) anatomy impacting nutrient absorption, gastric emptying, enervation, and gut microbiome, among other factors. RYGB surgery and accompanying weight loss also change circulating hormones and adipokines such as, but not limited to, increased levels of polypeptide YY (PYY), glucagon-like peptide 1 (GLP-1), and amylin; potential relative deficiencies of ghrelin and increases in growth hormone (GH); and reduction in proinflammatory markers. These established multifactorial contributors act to modify peripheral glucose concentration, which could then lead to CNS adaptations (black arrows). Purple arrows show areas for further investigation with an alternative model that proposes RYGB surgery and/or accompanying reduced adiposity impacts the CNS regulation of glucose metabolism, likely at the level of the hypothalamus, thereby contributing to postsurgical improvements in peripheral glucose concentrations in a bidirectional manner. B: CNS changes after RYGB surgery and weight loss as described by Almby et al. (5) during normoglycemia (5.0 mmol/L), glucose-lowering, and hypoglycemia (2.7 mmol/L). Figure created with BioRender (biorender.com).
See this image and copyright information in PMC

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References

    1. Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ 2014;349:g3961. - PMC - PubMed
    1. Lee CJ, Clark JM, Schweitzer M, et al. Prevalence of and risk factors for hypoglycemic symptoms after gastric bypass and sleeve gastrectomy. Obesity (Silver Spring) 2015;23:1079–1084 - PMC - PubMed
    1. Salehi M, Vella A, McLaughlin T, Patti ME. Hypoglycemia after gastric bypass surgery: current concepts and controversies. J Clin Endocrinol Metab 2018;103:2815–2826 - PMC - PubMed
    1. Goldfine AB, Patti ME. How common is hypoglycemia after gastric bypass? Obesity (Silver Spring) 2016;24:1210–1211 - PMC - PubMed
    1. Almby KE, Lundqvist MH, Abrahamsson N, et al. Effects of gastric bypass surgery on the brain: simultaneous assessment of glucose uptake, blood flow, neural activity, and cognitive function during normo- and hypoglycemia. Diabetes 2021;70:1265–1277 - PMC - PubMed

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