Metabolic improvements following Rouxen-Y surgery assessed by solid meal test in subjects with short duration type 2 diabetes

Sudha S. Shankar, Lori A. Mixson, Manu Chakravarthy, Robin Chisholm, Anthony J. Acton, Rose Marie Jones, Samer G. Mattar, Deborah L. Miller, Lea Petry, Chan R. Beals, S. Aubrey Stoch, David E. Kelley, Robert V. Considine

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Glucose homeostasis improves within days following Roux-en-Y gastric bypass (RYGB) surgery. The dynamic metabolic response to caloric intake following RYGB has been assessed using liquid mixed meal tolerance tests (MMTT). Few studies have evaluated the glycemic and hormonal response to a solid mixed meal in subjects with diabetes prior to, and within the first month following RYGB. Methods: Seventeen women with type 2 diabetes of less than 5 years duration participated. Fasting measures of glucose homeostasis, lipids and gut hormones were obtained pre- and post-surgery. MMTT utilizing a solid 4 oz chocolate pudding performed pre-, 2 and 4 weeks post-surgery. Metabolic response to 4 and 2 oz MMTT assessed in five diabetic subjects not undergoing surgery. Results: Significant reductions in fasting glucose and insulin at 3 days, and in fasting betatrophin, triglycerides and total cholesterol at 2 weeks post-surgery. Hepatic insulin clearance was greater at 3 days post-surgery. Subjects exhibited less hunger and greater feelings of fullness and satisfaction during the MMTT while consuming 52.9 ± 6. 5% and 51.0 ± 6.5% of the meal at 2 and 4 weeks post-surgery respectively. At 2 weeks post-surgery, glucose and insulin response to MMTT were improved, with greater GLP-1 and PYY secretion. Improved response to solid MMTT not replicated by consumption of smaller pudding volume in diabetic non-surgical subjects. Conclusions: With a test meal of size and composition representative of the routine diet of post-RYGB subjects, improved glycemic and gut hormone responses occur which cannot be replicated by reducing the size of the MMTT in diabetic subjects not undergoing surgery. Trial registration: Clinical Trials.gov Identifier: NCT00957957 August 11, 2009.

Original languageEnglish (US)
Article number10
JournalBMC Obesity
Volume4
Issue number1
DOIs
StatePublished - 2017

Keywords

  • C-peptide
  • GLP-1
  • Glucose
  • Gut hormones
  • Insulin
  • Meal test
  • Roux-en-Y

ASJC Scopus subject areas

  • Epidemiology
  • Endocrinology, Diabetes and Metabolism
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Health Policy
  • Public Health, Environmental and Occupational Health

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