Marlena M Holter1, Roxanne Dutia1, Sarah M Stano1, Ronald L Prigeon2, Peter Homel3, James J McGinty4, Scott J Belsley4, Christine J Ren5, Daniel Rosen6, Blandine Laferrère7. 1. New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY. 2. Baltimore Veterans Affairs Medical Center, Baltimore, MD. 3. Albert Einstein School of Medicine, Bronx, NY. 4. Division of Minimally Invasive Surgery, Department of Surgery, Mount Sinai St. Luke's Hospital, New York, NY. 5. New York University Langone Medical Center, New York, NY. 6. Wyckoff Heights Medical Center, Brooklyn, NY. 7. New York Obesity Nutrition Research Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY bbl14@columbia.edu.
Abstract
OBJECTIVE: The superior effect of Roux-en-Y gastric bypass (RYGB) on glucose control compared with laparoscopic adjustable gastric banding (LAGB) is confounded by the greater weight loss after RYGB. We therefore examined the effect of these two surgeries on metabolic parameters matched on small and large amounts of weight loss. RESEARCH DESIGN AND METHODS: Severely obese individuals with type 2 diabetes were tested for glucose metabolism, β-cell function, and insulin sensitivity after oral and intravenous glucose stimuli, before and 1 year after RYGB and LAGB, and at 10% and 20% weight loss after each surgery. RESULTS: RYGB resulted in greater glucagon-like peptide 1 release and incretin effect, compared with LAGB, at any level of weight loss. RYGB decreased glucose levels (120 min and area under the curve for glucose) more than LAGB at 10% weight loss. However, the improvement in glucose metabolism, the rate of diabetes remission and use of diabetes medications, insulin sensitivity, and β-cell function were similar after the two types of surgery after 20% equivalent weight loss. CONCLUSIONS: Although RYGB retained its unique effect on incretins, the superiority of the effect of RYGB over that of LAGB on glucose metabolism, which is apparent after 10% weight loss, was attenuated after larger weight loss.
OBJECTIVE: The superior effect of Roux-en-Y gastric bypass (RYGB) on glucose control compared with laparoscopic adjustable gastric banding (LAGB) is confounded by the greater weight loss after RYGB. We therefore examined the effect of these two surgeries on metabolic parameters matched on small and large amounts of weight loss. RESEARCH DESIGN AND METHODS: Severely obese individuals with type 2 diabetes were tested for glucose metabolism, β-cell function, and insulin sensitivity after oral and intravenous glucose stimuli, before and 1 year after RYGB and LAGB, and at 10% and 20% weight loss after each surgery. RESULTS: RYGB resulted in greater glucagon-like peptide 1 release and incretin effect, compared with LAGB, at any level of weight loss. RYGB decreased glucose levels (120 min and area under the curve for glucose) more than LAGB at 10% weight loss. However, the improvement in glucose metabolism, the rate of diabetes remission and use of diabetes medications, insulin sensitivity, and β-cell function were similar after the two types of surgery after 20% equivalent weight loss. CONCLUSIONS: Although RYGB retained its unique effect on incretins, the superiority of the effect of RYGB over that of LAGB on glucose metabolism, which is apparent after 10% weight loss, was attenuated after larger weight loss.
Authors: N B Jørgensen; S H Jacobsen; C Dirksen; K N Bojsen-Møller; L Naver; L Hvolris; T R Clausen; B S Wulff; D Worm; D Lindqvist Hansen; S Madsbad; J J Holst Journal: Am J Physiol Endocrinol Metab Date: 2012-04-24 Impact factor: 4.310
Authors: Katherine Samaras; Alexander Viardot; Natalia K Botelho; Alicia Jenkins; Reginald V Lord Journal: Diabetologia Date: 2013-09-13 Impact factor: 10.122
Authors: Philip R Schauer; Deepak L Bhatt; John P Kirwan; Kathy Wolski; Stacy A Brethauer; Sankar D Navaneethan; Ali Aminian; Claire E Pothier; Esther S H Kim; Steven E Nissen; Sangeeta R Kashyap Journal: N Engl J Med Date: 2014-03-31 Impact factor: 91.245
Authors: Anita P Courcoulas; Steven H Belle; Rebecca H Neiberg; Sheila K Pierson; Jessie K Eagleton; Melissa A Kalarchian; James P DeLany; Wei Lang; John M Jakicic Journal: JAMA Surg Date: 2015-10 Impact factor: 14.766
Authors: Nancy Puzziferri; Paul A Nakonezny; Edward H Livingston; Thomas J Carmody; David A Provost; A John Rush Journal: Ann Surg Date: 2008-08 Impact factor: 12.969
Authors: Anny H Xiang; Enrique Trigo; Mayra Martinez; Namir Katkhouda; Elizabeth Beale; Xinhui Wang; Jun Wu; Ting Chow; Cortney Montgomery; Krishna S Nayak; Fadi Hendee; Thomas A Buchanan Journal: Diabetes Care Date: 2018-10-03 Impact factor: 19.112
Authors: Mihoko Yoshino; Brandon D Kayser; Jun Yoshino; Richard I Stein; Dominic Reeds; J Christopher Eagon; Shaina R Eckhouse; Jeramie D Watrous; Mohit Jain; Rob Knight; Kenneth Schechtman; Bruce W Patterson; Samuel Klein Journal: N Engl J Med Date: 2020-08-20 Impact factor: 91.245