Glucose-Stimulated Insulin Secretion in Gastric Bypass Patients with Hypoglycemic Syndrome: No Evidence for Inappropriate Pancreatic β-cell Function
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Roux-en-Y gastric bypass surgery (RYGB) has been associated with a hypoglycemic syndrome characterized by postprandial hypoglycemia and hyperinsulinemia. The syndrome is believed to occur due to insulin hypersecretion from either pancreatic β-cell hyperplasia or hyperfunction.
Eight RYGB patients with hypoglycemic syndrome had insulin secretion rates determined during a 240-min graded intravenous glucose infusion. They were compared to 34 nondiabetic, nonsurgical individuals who were divided based on their insulin sensitivity status as measured by the insulin suppression test: insulin-sensitive (n = 8), insulin intermediate (n = 7), and insulin-resistant (n = 19).
RYGB patients had insulin concentrations and HOMA-IR similar to the insulin-sensitive reference group. In addition, integrated insulin secretion rates were comparable to the insulin-sensitive group and significantly lower than the insulin intermediate (p ≤ 0.046) and insulin-resistant groups (p ≤ 0.001). Pancreatic β-cell sensitivity to glucose (slope relating glucose and ISR) was lowest in the RYGB group (p ≤ 0.04).
Patients with hypoglycemic syndrome post-RYGB do not have generalized hypersecretion of insulin and appear to have appropriate insulin secretion rate in response to intravenous glucose.
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- Glucose-Stimulated Insulin Secretion in Gastric Bypass Patients with Hypoglycemic Syndrome: No Evidence for Inappropriate Pancreatic β-cell Function
Volume 20, Issue 8 , pp 1110-1116
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- Gastric bypass
- Insulin secretion
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- 1. Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- 2. Stanford University Medical Center, 300 Pasteur Drive, Room S025, Stanford, CA, 94305-5103, USA