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
Clinical Trial
. 2013 Sep;62(9):3027-32.
doi: 10.2337/db12-1762. Epub 2013 Apr 22.

Very low-calorie diet mimics the early beneficial effect of Roux-en-Y gastric bypass on insulin sensitivity and β-cell Function in type 2 diabetic patients

Clifton Jackness  1 , Wahida Karmally, Gerardo Febres, Irene M Conwell, Leaque Ahmed, Marc Bessler, Donald J McMahon, Judith Korner
Affiliations
Clinical Trial

Very low-calorie diet mimics the early beneficial effect of Roux-en-Y gastric bypass on insulin sensitivity and β-cell Function in type 2 diabetic patients

Clifton Jackness et al. Diabetes. 2013 Sep.

Abstract

Marked improvement in glycemic control occurs in patients with type 2 diabetes mellitus shortly after Roux-en-Y gastric bypass surgery (RYGB) and before there is major weight loss. The objective of this study was to determine whether the magnitude of this change is primarily due to caloric restriction or is unique to the surgical procedure. We studied eleven subjects who underwent RYGB and fourteen subjects mean-matched for BMI, HbA1c, and diabetes duration who were admitted to our inpatient research unit and given a very low-calorie diet (VLCD) of 500 kcal/day with a macronutrient content similar to that consumed by patients after RYGB. Frequently sampled intravenous glucose tolerance tests were performed before and after interventions. Both groups lost an equivalent amount of weight over a mean study period of 21 days. Insulin sensitivity, acute insulin secretion after intravenous glucose administration, and β-cell function as determined by disposition index improved to a similar extent in both groups. Likewise, changes in fasting glucose and fructosamine levels were similar. Based on these data, VLCD improves insulin sensitivity and β-cell function just as well as RYGB in the short term.

Trial registration: ClinicalTrials.gov NCT00627484.

PubMed Disclaimer

Figures

FIG. 1.
FIG. 1.
Changes in Si (A), AIR (B), DI (C), and ACPR (D) for all subjects shown individually. *P < 0.05, **P < 0.01, ***P < 0.001 vs. baseline.
FIG. 2.
FIG. 2.
Graphic representation of the relationship between insulin sensitivity and insulin secretion before and after interventions.
See this image and copyright information in PMC

Comment in

References

    1. Finkelstein EA, Khavjou OA, Thompson H, et al. . Obesity and severe obesity forecasts through 2030. Am J Prev Med 2012;42:563–570 - PubMed
    1. DeFronzo RA, Bonadonna RC, Ferrannini E. Pathogenesis of NIDDM. A balanced overview. Diabetes Care 1992;15:318–368 - PubMed
    1. Leahy JL, Hirsch IB, Peterson KA, Schneider D. Targeting beta-cell function early in the course of therapy for type 2 diabetes mellitus. J Clin Endocrinol Metab 2010;95:4206–4216 - PubMed
    1. Henry RR, Scheaffer L, Olefsky JM. Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1985;61:917–925 - PubMed
    1. Kelley DE, Wing R, Buonocore C, Sturis J, Polonsky K, Fitzsimmons M. Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1993;77:1287–1293 - PubMed

Publication types

Associated data