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The Recovery of Beta-Cell Function is Critical for Antidiabetic Outcomes of Gastric Bypass in Asian Subjects with Type 2 Diabetes and a Body Mass Index Below 30

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Abstract

Type 2 diabetes (T2D) in Asian populations is characterized by a lower body mass index (BMI) than in Caucasian cases. This pilot study investigated antidiabetic outcomes after a Roux-en-Y gastric bypass (RYGB) in Asian subjects with T2D and BMI < 30. Fifteen Koreans with poorly controlled T2D and BMI 23–30 underwent RYGB. Two years after RYGB, seven patients achieved HbA1c < 6.5% without medication (target-achieved). The other cases also showed improved glycemic control. The insulin secretory response during an oral glucose tolerance test was significantly restored in the target-achieved group. Postoperative changes in insulin sensitivity and body weight did not differ between these groups. Beta-cell function improvement is an important determinant of the long-term antidiabetic outcomes of RYGB in Asian subjects with BMI < 30.

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Acknowledgements

The authors thank Boston BioEdit Inc., for assistance with the preparation of the manuscript.

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Authors and Affiliations

  1. Diabetes Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Obin Kwon, Ji Hee Yu & Min-Seon Kim

  2. Division of Endocrinology and Metabolism, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea

    Obin Kwon, Ji Hee Yu & Min-Seon Kim

  3. Department of Family Medicine, Inha University School of Medicine, 7-206, 3-Ga, Sinheung-dong, Jung-Gu, Incheon, 22332, South Korea

    Yeon Ji Lee

  4. Department of Surgery, Inha University School of Medicine, 7-206, 3-Ga, Sinheung-dong, Jung-Gu, Incheon, 22332, South Korea

    Yoonseok Heo

Authors
  1. Obin Kwon
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  2. Yeon Ji Lee
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  3. Ji Hee Yu
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  4. Min-Seon Kim
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  5. Yoonseok Heo
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Corresponding authors

Correspondence to Min-Seon Kim or Yoonseok Heo.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Funding

This work was supported by grants from the Korean Health Technology R&D Project (H15C1322), Ministry of Health & Welfare, Republic of Korea (for Y.H.), and the National Research Foundation of Korea (2013M3C7A1056024, 2015M3A9E7029172 for M.-S.K.).

Ethical Approval

The study conforms to the Declaration of Helsinki II and was approved by the Institutional Review Board of Inha University Hospital and registered with the international clinical trial registry (#NCT01735253).

Informed Consent

All of the included subjects agreed to participate in our analysis and signed informed consent.

Additional information

Obin Kwon and Yeon Ji Lee were both authors who equally contributed to this study.

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Supplementary Figure 1

Comparison of indices of (a) insulin resistance, (b) insulin sensitivity, (c) early-phase insulin secretion, and (d) compensatory insulin secretion for insulin resistance, according to the HbA1c level 2 years after Roux-en-Y gastric bypass surgery (RYGB). *P < 0.05 compared with the target-not-achieved group. Comparisons of group differences at a given time point were performed using the Wilcoxon signed-rank test. (JPEG 200 kb)

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Kwon, O., Lee, Y.J., Yu, J.H. et al. The Recovery of Beta-Cell Function is Critical for Antidiabetic Outcomes of Gastric Bypass in Asian Subjects with Type 2 Diabetes and a Body Mass Index Below 30. OBES SURG 27, 541–544 (2017). https://doi.org/10.1007/s11695-016-2455-y

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  • DOI: https://doi.org/10.1007/s11695-016-2455-y

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