Surgery Today

, Volume 44, Issue 2, pp 340–348 | Cite as

Effects of duodeno-jejunal bypass on glucose metabolism in obese rats with type 2 diabetes

  • Hirofumi Imoto
  • Chikashi Shibata
  • Fumie Ikezawa
  • Daisuke Kikuchi
  • Soutoku Someya
  • Koh Miura
  • Takeshi Naitoh
  • Michiaki Unno
Original Article



To evaluate the foregut and hindgut hypotheses for metabolic surgery in obese rats with diabetes.


Otsuka Long-Evans Tokushima fatty rats were divided into a sham operation group, a partial duodeno-jejunal bypass (P-DJB) group, and a complete DJB (C-DJB) group. P-DJB is a model to test foregut hypothesis, whereas C-DJB is a model to test both hypotheses. We performed oral glucose tolerance tests (OGTT) on all groups at baseline, and then 4 and 8 weeks postoperatively. The rats were killed thereafter and the plasma levels of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) were measured. A separate sub-group of C-DJB rats underwent OGTT after treatment with the GLP-1 antagonist, the PYY antagonist, or saline.


Marked improvement of the blood glucose control during the OGTT was noted 8 weeks after C-DJB, but not 8 weeks after P-DJB or the sham operation. The serum GLP-1 and PYY levels were higher in the C-DJB group than in the other two groups. Pretreatment with the GLP-1 antagonist increased the blood glucose levels 30 min after the OGTT in the C-DJB rats.


Improvement in glucose metabolism after DJB was associated with the inflow of bile and pancreatic juice into the ileum, supporting validity of the hindgut hypothesis. GLP-1 appears to play a role in this improvement.


Duodeno-jejunal bypass Glucagon-like peptide-1 Peptide YY 



We thank Dr. Kazuya Kawano from the Tokushima Research Institute, Otsuka Pharmaceutical Co., Tokushima, Japan for the generous gift of the OLETF rats; Ms. Emiko Shibuya for her technical assistance; and Dr. Michael G. Sarr, Department of Surgery, Mayo Clinic, Minnesota, USA, for reviewing this manuscript. This study was supported by a Grant-In-Aid from the Japanese Society for Parenteral and Enteral Nutrition (2009).

Conflict of interest

Hirofumi Imoto and his co-authors have no potential conflicts of interest or financial interest to disclose.


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Copyright information

© Springer Japan 2013

Authors and Affiliations

  • Hirofumi Imoto
    • 1
  • Chikashi Shibata
    • 1
  • Fumie Ikezawa
    • 1
  • Daisuke Kikuchi
    • 1
  • Soutoku Someya
    • 1
  • Koh Miura
    • 1
  • Takeshi Naitoh
    • 1
  • Michiaki Unno
    • 1
  1. 1.Division of Biological Regulation and Oncology, Department of SurgeryTohoku University Graduate School of MedicineSendaiJapan

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