Temporal Effects of Sleeve Gastrectomy on Glucose-Insulin Homeostasis and Incretin Hormone Response at 1 and 6 Months

Background Bariatric surgery is an effective treatment for morbid obesity and glycaemic dysfunction. Objectives The aim of the work was to examine both the static and dynamic changes of glucose-insulin homeostasis and incretin hormone response following sleeve gastrectomy (SG) in a sample of 55 part...

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Bibliographic Details
Published in:Obesity surgery 2020-06, Vol.30 (6), p.2243-2250
Main Authors: Prior, S. L., Churm, R., Min, T., Dunseath, G. J., Barry, J. D., Stephens, J. W.
Format: Article
Language:English
Subjects:
Blood Glucose
Diabetes Mellitus, Type 2 - surgery
Gastrectomy
Gastrointestinal surgery
Glucose
Homeostasis
Humans
Incretins
Insulin
Laparoscopy
Medicine
Medicine & Public Health
Obesity
Obesity, Morbid - surgery
Original Contributions
Peptides
Prospective Studies
Surgery
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Summary:Background Bariatric surgery is an effective treatment for morbid obesity and glycaemic dysfunction. Objectives The aim of the work was to examine both the static and dynamic changes of glucose-insulin homeostasis and incretin hormone response following sleeve gastrectomy (SG) in a sample of 55 participants preoperatively and 1 month and 6 months postoperatively. The focus was on a sample of patients with impaired glucose tolerance and type 2 diabetes (T2D). Setting Morriston Hospital, UK. Methods Prospective study comprising of 55 participants with impaired glucose homeostasis and T2D undergoing SG (mean body mass index [BMI] 50.4 kg/m 2 , mean glycated haemoglobin [A1C] 7.4%). Serial measurements of glucose, insulin, C-peptide, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic hormone (GIP) were performed during oral glucose tolerance testing preoperatively and 1 and 6 months postoperatively. Areas under the curve (AUC) were examined at 30, 60, and 120 min. Results We observed significant improvements in measures of obesity, as well as static and dynamic measures of glucose, insulin, C-peptide and HOMA. Furthermore, significant increases in GLP-1 response as early as 6 months postoperatively were also seen. Conclusions To our knowledge, no study has examined the detailed dynamic changes in glucose and insulin homeostasis in this number of participants undergoing SG in relation to incretin hormones GIP and GLP-1. This current study supports the role of SG for the treatment of obesity-related glucose dysregulation.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-020-04457-9