Acute Effect of Roux-En-Y Gastric Bypass on Whole-Body Insulin Sensitivity: A Study with the Euglycemic-Hyperinsulinemic Clamp

Abstract

A month after RYGBP, fasting glucose metabolism improves independent of a change in peripheral insulin sensitivity.

Early Enhancements of Hepatic and Later of Peripheral Insulin Sensitivity Combined With Increased Postprandial Insulin Secretion Contribute to Improved Glycemic Control After Roux-en-Y Gastric Bypass

“…Also, at 1 week after surgery, glucose disposal could still be influenced by postoperative stress (40,41), possibly counteracting a beneficial effect of surgery. However, lack of improvement in glucose disposal is in line with other clamp studies performed 4 weeks after RYGB when surgical stress has abated (17,42). Elevated FA levels also act to reduce glucose disposal (43,44) and were seen in both groups 1 week after RYGB, in accordance with previous studies early after RYGB (12,22,42) and calorie restriction (22).…”

Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity

“…The first is immediately after surgery, at which time hepatic, but not peripheral, S I improves in response to acute energy restriction (4-6), while greater, protracted weight loss appears to be more strongly associated with improved peripheral S I (7,8). Even with significant weight loss 1 year following RYBG surgery, peripheral S I is still low compared with that of lean metabolically healthy individuals (3,5,6,9).Exercise is considered a cornerstone for obesity treatment, and while it is not generally viewed to cause substantial body weight reduction (10), it can potently improve peripheral S I and glucose control (11-13) and can reduce the risk of T2D and cardiovascular disease (14,15). There is general consensus that even a single session of moderate intensity exercise can induce an improvement in S I (16).…”

“…The first is immediately after surgery, at which time hepatic, but not peripheral, S I improves in response to acute energy restriction (4-6), while greater, protracted weight loss appears to be more strongly associated with improved peripheral S I (7,8). Even with significant weight loss 1 year following RYBG surgery, peripheral S I is still low compared with that of lean metabolically healthy individuals (3,5,6,9).…”

“…A 50% dextrose bolus (0.3 g/kg body mass) was administered after fasting samples were collected, and insulin (0.025 U/kg body mass) was then injected at minute 20. Blood samples were collected in EDTA tubes at minutes 2,3,4,5,6,8,10,12,14,16,19,22,23,24,25,27,30,40,50,60,70,80,90,100,120,140,160, and 180. Plasma samples were stored at −80°C until later analyses.…”

PGC1α gene Gly482Ser polymorphism predicts improved metabolic, inflammatory and vascular outcomes following bariatric surgery

“…Moreover, this index is widely used in the evaluation of obese subjects, and is frequently found to correlate very well with a number of metabolic and inflammatory parameters. 15 Regarding the metabolic and biochemical parameters evaluated, glucose was the only one that underwent a significantly greater reduction in the Gly/Ser þ Ser/Ser group. Although none of the remaining parameters related to glucose homeostasis underwent significantly different variations over time, it is clear that the mean levels of insulin, homeostatic model assessment-insulin resistance and leptin, which were higher in the Gly/Ser þ Ser/Ser group at baseline, became lower after 12 months.…”