Restoration of high-frequency glucose-entrained insulin oscillations in obese subjects with type 2 diabetes after biliopancreatic diversion.
Academic Article
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
Minimal glucose infusions are known to entrain insulin oscillations in patients with normal glucose tolerance (NGT) but not in patients with type 2 diabetes (T2D).To investigate whether weight loss after a version of biliopancreatic diversion (BPD) can restore the glucose entrainment of high-frequency insulin oscillations in morbidly obese NGT or T2D patients.University Hospital, Greece.We prospectively studied 9 NGT controls (body mass index [BMI] 23.3±1.6 kg/m2), 9 obese NGT patients (BMI 51.1±12.7 kg/m2), and 9 obese T2D patients (BMI 56.8±11.6 kg/m2). Patients were studied before and 1.5 years after BPD. Insulin was sampled every minute for 90 minutes. Glucose (6 mg/kg weight) was infused every 10 minutes for 1 minute. Regularity of insulin pulses was estimated by autocorrelation analysis, spectral analysis, approximate entropy/sample entropy (ApEn/SampEn), and insulin pulsatility by deconvolution analysis.Postoperatively, glucose and insulin concentrations of NGT and T2D patients decreased to control levels and BMI to 31.3±6.3 for NGT patients and 34.9±9.9 kg/m2 for T2D patients. Preoperatively, glucose entrainment was absent in all T2D and in 4 NGT patients as assessed with spectral analysis and in 8 and 4, respectively, as assessed with autocorrelation and deconvolution analysis. Postoperatively, it was restored to normal in all patients. ApEn/SampEn decreased significantly only in the T2D group postoperatively.BPD restores the glucose entrainment of high-frequency insulin oscillations in obese NGT and T2D patients after marked weight loss and normalizes glucose levels and insulin sensitivity, thus demonstrating recovery of β-cell glucose sensing.Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
publication date
published in
Research
keywords
Adult
Biliopancreatic Diversion
Blood Glucose
Body Mass Index
Case-Control Studies
Diabetes Mellitus, Type 2
Fasting
Female
Glucose
Glucose Tolerance Test
Humans
Infusions, Intravenous
Insulin
Insulin Resistance
Insulin-Secreting Cells
Male
Obesity, Morbid
Postoperative Care
Prospective Studies
Sweetening Agents
Weight Loss
Identity
Digital Object Identifier (DOI)
PubMed ID
Additional Document Info
start page
end page
volume
number