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Early Changes in Incretin Secretion After Laparoscopic Duodenal–Jejunal Bypass Surgery in Type 2 Diabetic Patients

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Abstract

Background

A stomach-preserving duodenal–jejunal bypass (DJB) has been used for the treatment of type 2 diabetes mellitus (DM) since Rubino et al. first reported a prospective trial. However, there has been no report on changes in incretin secretion after DJB. We aimed to investigate whether DJB changes incretin secretion in nonmorbidly obese type 2 diabetic patients.

Methods

The inclusion criteria in this prospective study were: patient age of 20–65 years, body mass index of <30 kg/m2, a history of type 2 DM for ≤10 years, and fasting C-peptide ≥0.3 nmol/l. Six patients with type 2 DM without morbid obesity underwent DJB. Fasting plasma glucose and glycated hemoglobin (HbA1c) were measured. An oral glucose tolerance test (OGTT) was performed with measurement of glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), insulin, C-peptide, and glucagon. The study subjects were followed up for 6 months.

Results

The body weight of patients declined after surgery. The area under the curve (AUC) of glucose, peak glucose levels during OGTT, and HbA1c also declined until 3 months postoperatively. The AUC of C-peptide and insulin tended to increase postoperatively. The AUC of glucagon had a significant increase at 6 months postoperatively. The AUC of active GLP-1 increased at 1 month and at 6 months postoperatively. There was no change in the AUC of total GIP.

Conclusion

Our data suggest that DJB increases GLP-1 secretion in nonmorbidly obese type 2 diabetic patients. However, long-term data are needed to confirm this finding.

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Conflict of interest disclosure

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, The Catholic University of Korea, Seoul, Korea

    Hong Chan Lee & Eungkook Kim

  2. Department of Internal Medicine, The Catholic University of Korea, Yeouido St. Mary’s Hospital, 62 Yeouido-dong, Youngdeungpo-gu, Seoul, 150-713, Korea

    Mee Kyoung Kim, Hyuk Sang Kwon & Ki-Ho Song

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  1. Hong Chan Lee
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  2. Mee Kyoung Kim
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  3. Hyuk Sang Kwon
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Correspondence to Ki-Ho Song.

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Lee, H.C., Kim, M.K., Kwon, H.S. et al. Early Changes in Incretin Secretion After Laparoscopic Duodenal–Jejunal Bypass Surgery in Type 2 Diabetic Patients. OBES SURG 20, 1530–1535 (2010). https://doi.org/10.1007/s11695-010-0248-2

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