Timothy P Gavin1, Jacob M Ernst2, Sarah E Caudill2, G Lynis Dohm3, Walter J Pories4, Moahad Dar5, Melissa A Reed6. 1. Department of Health and Kinesiology, Purdue University, West Lafayette, IN. Electronic address: gavin1@purdue.edu. 2. Department of Kinesiology, East Carolina University, Greenville, NC; Human Performance Laboratory, East Carolina University, Greenville, NC. 3. Department of Physiology, East Carolina University, Greenville, NC; East Carolina Diabetes and Obesity Institute at East Carolina University, Greenville, NC. 4. Department of Surgery, East Carolina University, Greenville, NC; East Carolina Diabetes and Obesity Institute at East Carolina University, Greenville, NC. 5. Department of Medicine, East Carolina University, Greenville, NC; East Carolina Diabetes and Obesity Institute at East Carolina University, Greenville, NC. 6. Department of Kinesiology, West Chester University, West Chester, PA.
Abstract
BACKGROUND: After initial onset, adequate glycemic control in patients with type 2 diabetes (T2DM) presents a continuing challenge even with aggressive pharmacologic treatment, and longer disease duration is associated with poorer resolution in response to Roux-en Y gastric bypass (RYGB). Skeletal muscle insulin sensitivity is an important determinant of glycemic control. We investigated whether skeletal muscle insulin sensitivity is predictive of T2DM resolution with RYGB and is in general lower in patients with longer-duration T2DM. METHODS: Insulin sensitivity (SI) and the acute response to glucose (AIRg) were calculated by MINMOD analysis from glucose and insulin obtained during a modified frequently sampled intravenous glucose tolerance test. RESULTS: Pre-RYGB SI and duration but not AIRg were predictive of T2DM resolution by RYGB. In addition, HbA1c was greater and SI and AIRg lower in long- (8+ years) compared with short-duration (1- to 7-year) T2DM. Multiple linear regression analysis demonstrated that SI explained 32% and AIRg 21% of the variance in HbA1c, respectively. CONCLUSION: The current results suggest that pre-RYGB SI is predictive of T2DM resolution after RYGB, skeletal muscle insulin sensitivity and β-cell function worsen after the onset of T2DM, and low skeletal muscle insulin sensitivity as well as low β cell function contribute to poor glycemic control in T2DM.
BACKGROUND: After initial onset, adequate glycemic control in patients with type 2 diabetes (T2DM) presents a continuing challenge even with aggressive pharmacologic treatment, and longer disease duration is associated with poorer resolution in response to Roux-en Y gastric bypass (RYGB). Skeletal muscle insulin sensitivity is an important determinant of glycemic control. We investigated whether skeletal muscle insulin sensitivity is predictive of T2DM resolution with RYGB and is in general lower in patients with longer-duration T2DM. METHODS:Insulin sensitivity (SI) and the acute response to glucose (AIRg) were calculated by MINMOD analysis from glucose and insulin obtained during a modified frequently sampled intravenous glucose tolerance test. RESULTS: Pre-RYGB SI and duration but not AIRg were predictive of T2DM resolution by RYGB. In addition, HbA1c was greater and SI and AIRg lower in long- (8+ years) compared with short-duration (1- to 7-year) T2DM. Multiple linear regression analysis demonstrated that SI explained 32% and AIRg 21% of the variance in HbA1c, respectively. CONCLUSION: The current results suggest that pre-RYGB SI is predictive of T2DM resolution after RYGB, skeletal muscle insulin sensitivity and β-cell function worsen after the onset of T2DM, and low skeletal muscle insulin sensitivity as well as low β cell function contribute to poor glycemic control in T2DM.
Authors: Nicole M Gilbertson; Andrew S Paisley; Sibylle Kranz; Arthur Weltman; Jennifer L Kirby; Peter T Hallowell; Steven K Malin Journal: Obes Surg Date: 2017-12 Impact factor: 4.129
Authors: Vishesh Khanna; Steven K Malin; James Bena; Beth Abood; Claire E Pothier; Deepak L Bhatt; Steven Nissen; Richard Watanabe; Stacy A Brethauer; Philip R Schauer; John P Kirwan; Sangeeta R Kashyap Journal: Obesity (Silver Spring) Date: 2015-02-03 Impact factor: 5.002
Authors: Mahmoud A Alfaqih; Aisha Al-Hawamdeh; Zouhair O Amarin; Yousef S Khader; Khawla Mhedat; Mohammed Z Allouh Journal: Biomed Res Int Date: 2022-04-27 Impact factor: 3.246