Obesity Surgery

, Volume 19, Issue 2, pp 217–229 | Cite as

Do Incretins Play a Role in the Remission of Type 2 Diabetes after Gastric Bypass Surgery: What are the Evidence?

  • Mousumi Bose
  • Blanca Oliván
  • Julio Teixeira
  • F. Xavier Pi-Sunyer
  • Blandine Laferrère
Review

Abstract

Gastric bypass surgery (GBP), in addition to weight loss, results in dramatic remission of type 2 diabetes (T2DM). The mechanisms by which this remission occurs are unclear. Besides weight loss and caloric restriction, the changes in gut hormones that occur after GBP are increasingly gaining recognition as key players in glucose control. Incretins are gut peptides that stimulate insulin secretion postprandially; the levels of these hormones, particularly glucagon-like peptide-1, increase after GBP in response to nutrient stimulation. Whether these changes are causal to changes in glucose homeostasis remain to be determined. The purpose of this review is to assess the evidence on incretin changes and T2DM remission after GBP, and the possible mechanisms by which these changes occur. Our goals are to provide a thorough update on this field of research so that recommendations for future research and criteria for bariatric surgery can be evaluated.

Keywords

Incretin GLP-1 GIP Diabetes Gastric bypass Insulin Weight loss 

Abbreviations

T2DM

type 2 diabetes mellitus

GBP

gastric bypass surgery

GIP

gastric inhibitory peptide-1

GLP-1

glucagon-like peptide-1

DPP-IV

dipeptidyl peptidase-IV

HbA1C

hemoglobin A1C

VBG

vertical banded gastroplasty

GB

gastric banding

JIB

jejunoileal bypass

BPD

biliopancreatic diversion

BMI

body mass index

OGTT

oral glucose tolerance test

HGP

hepatic glucose production

HOMA-IR

homeostasis model assessment for insulin resistance

QUICKI

quantitative insulin sensitivity check index

IVGTT

intravenous glucose tolerance test

PYY

peptide YY

IGT

impaired glucose tolerance

FSIVGTT

frequently sampled intravenous glucose tolerance test

AUC

area under the curve

IT

ileal interposition

GK

Goto-Kakizaki

GJB

gastrojejunal bypass

DJB

duodenal-jejunal bypass

GJ

gastrojejunostomy

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Mousumi Bose
    • 1
    • 3
  • Blanca Oliván
    • 1
  • Julio Teixeira
    • 2
  • F. Xavier Pi-Sunyer
    • 1
  • Blandine Laferrère
    • 1
  1. 1.New York Obesity Research Center, St. Luke’s Roosevelt Hospital CenterColumbia University College of Physicians and SurgeonsNew YorkUSA
  2. 2.Division of Bariatric Surgery, St. Luke’s Roosevelt Hospital CenterColumbia University College of Physicians and SurgeonsNew YorkUSA
  3. 3.New York Obesity Research CenterSt. Luke’s Roosevelt Hospital CenterNew YorkUSA

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