Beta-cell sensitivity to glucose is impaired after gastric bypass surgery.
Abstract
AIMS: Patients with Roux-en-Y gastric bypass surgery (GB) have exaggerated postprandial
insulin secretion, which has been attributed to increased meal glucose appearance
and enhanced incretin effect. Here we sought to determine β-cell glucose sensitivity
in the absence of meal stimulation and insulinotropic gut factors. MATERIALS AND METHODS:
Twelve non-diabetic subjects with prior GB, and 7 matched non-surgical controls with
normal glucose tolerance were studied. Blood glucose and insulin secretion rates were
measured during a graded glucose infusion at increasing and then decreasing rates.
Insulin sensitivity (SI ) and glucose effectiveness (SG ) were determined by the minimal
model. RESULTS: The GB subjects had comparable SI to the controls. The GB subjects
had relative hyperglycemia during highest dose of glucose infusion associated with
significantly reduced β-cell glucose sensitivity throughout both step-up (GB: 34±6,
CN: 82±9 pmol.min-1 .mM-1 .L, p<0.0001) and step-down (GB: 31±6, CN: 74±9 pmol.min-1
.mM-1 .L, p<0.0001) phases of the glucose infusion. The GB subjects also had reduced
SG (GB: 0.04±0.00, CN: 0.07±0.01 min-1 , p = 0.004). CONCLUSION: In the absence of
enteric stimuli β-cell sensitivity to changes in glycemia is blunted among individuals
with GB, indicating a significant shift in a fundamental property of β-cell function
several years after surgery.
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https://hdl.handle.net/10161/15909Published Version (Please cite this version)
10.1111/dom.13165Publication Info
Salehi, Marzieh; Gastaldelli, Amalia; & D'Alessio, David A (2017). Beta-cell sensitivity to glucose is impaired after gastric bypass surgery. Diabetes Obes Metab. 10.1111/dom.13165. Retrieved from https://hdl.handle.net/10161/15909.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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David A D'Alessio
James B. Wyngaarden Distinguished Professor of Medicine

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