The Importance of GLP-1 in Post RYGB Improvement in Glycaemic Control Type 2 Diabetic Subjects

Conditions

Type 2 Diabetes

Keywords

RYGB, Bariatric Surgery, Glucagon-like-peptide 1

Brief summary

After Roux-en-Y gastric bypass (RYGB) meal induced GLP-1 secretion is dramatically increased, while beta-cell function is increased in type 2 diabetic (T2D) subjects. The aim of this study is to establish causality between the two observations. By meal testing 10 T2D subjects with infusion of saline or exendin (9-39), a GLP-1R specific blocker, before and 1 week and 3 months after RYGB we hope to demonstrate the role of GLP-1 in improveing beta-cell function and maintaing glucose tolerance after RYGB in T2D subjects. Furthermore, effects of GLP-1 rec blockade before and after RYGB on ad libitum energy intake is examined

Detailed description

After Roux-en-Y gastric bypass (RYGB) meal induced GLP-1 secretion is dramatically increased, while beta-cell function is increased in type 2 diabetic (T2D) subjects. The aim of this study is to establish causality between the two observations. By meal testing 10 T2D subjects with infusion of saline or exendin (9-39), a GLP-1R specific blocker, before and 1 week and 3 months after RYGB we hope to demonstrate the role of GLP-1 in improveing beta-cell function and maintaing glucose tolerance after RYGB in T2D subjects. Furthermore, effects of GLP-1 rec blockade before and after RYGB on ad libitum energy intake is examined

Palleja A, Kashani A, Allin KH, Nielsen T, Zhang C, Li Y, Brach T, Liang S, Feng Q, Jørgensen NB, Bojsen-Møller KN, Dirksen C, Burgdorf KS, Holst JJ, Madsbad S, Wang J, Pedersen O, Hansen T, Arumugam M.

2016-06-15225 citations

10.1186/s13073-016-0312-1

Effects of Roux-en-Y gastric bypass on fasting and postprandial inflammation-related parameters in obese subjects with normal glucose tolerance and in obese subjects with type 2 diabetes.

Lindegaard KK, Jorgensen NB, Just R, Heegaard PM, Madsbad S.

2015-02-2436 citations

10.1186/s13098-015-0012-9

Interventions

PROCEDURERoux-en-Y Gastric Bypass

On two separate experimental days before, 1 wk, and 3 months after RYGB, subjects are given a liquid meal test during Exendin 9-39 (900 pmol/min/kg)or saline infusion. The order of the infusions is randomized. At end of study day an ad libitum meal is served.

Study design

Allocation

NA

Intervention model

SINGLE_GROUP

Primary purpose

BASIC_SCIENCE

Masking

SINGLE (Subject)

Eligibility

Sex/Gender

ALL

Age

25 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Fasting glucose \> 7.0 mM, 2h glucose after OGTT \> 11.0 mM. BMI \> 35. HbA1c \< 8.5%. Fasting C-peptide \> 700 pM. Elegible for RYGB.

Exclusion criteria

* Dysregulated hypothyroidism, hyperthyroidism, anaemia.

Design outcomes

Primary

Measure	Time frame	Description
Beta cell glucose sensitivity	1 week and 3 months after RYGB	change in prehepatic insulin secretionrate relative to glucose increments

Secondary

Measure	Time frame	Description
Glucose tolerance	1 week and 3 months after RYGB	change in AUC glucose
Ad libitum food intake	3 months after surgery	Change in amount of calories ingested

Countries

Denmark

Outcome results

None listed