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 BoseEmail author
  • Blanca Oliván
  • Julio Teixeira
  • F. Xavier Pi-Sunyer
  • Blandine Laferrère


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.


Incretin GLP-1 GIP Diabetes Gastric bypass Insulin Weight loss 



type 2 diabetes mellitus


gastric bypass surgery


gastric inhibitory peptide-1


glucagon-like peptide-1


dipeptidyl peptidase-IV


hemoglobin A1C


vertical banded gastroplasty


gastric banding


jejunoileal bypass


biliopancreatic diversion


body mass index


oral glucose tolerance test


hepatic glucose production


homeostasis model assessment for insulin resistance


quantitative insulin sensitivity check index


intravenous glucose tolerance test


peptide YY


impaired glucose tolerance


frequently sampled intravenous glucose tolerance test


area under the curve


ileal interposition




gastrojejunal bypass


duodenal-jejunal bypass





The authors would like to thank Ms. Baani Bawa, Ms. Adrienne O’Reilly, and Ms. Caroline Poryles for their assistance in manuscript preparation. This work was funded by the National Institute of Health training grant #DK07559.

Author Disclosures

M. Bose, B. Oliván, J. Teixeira, F.X. Pi-Sunyer, and B. Laferrère have no conflicts of interest.


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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Mousumi Bose
    • 1
    • 3
    Email author
  • 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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