Effects of glucagon like peptide-1 to mediate glycemic effects of weight loss surgery.

Published

Journal Article (Review)

To date, weight loss surgeries are the most effective treatment for obesity and glycemic control in patients with type 2 diabetes. Roux-en-Y gastric bypass surgery (RYGB) and sleeve gastrectomy (SG), two widely used bariatric procedures for the treatment of obesity, induce diabetes remission independent of weight loss while glucose improvement after adjustable gastric banding (AGB) is proportional to the amount of weight loss. The immediate, weight-loss independent glycemic effect of gastric bypass has been attributed to postprandial hyperinsulinemia and an enhanced incretin effect. The rapid passage of nutrients into the intestine likely accounts for significantly enhanced glucagon like-peptide 1 (GLP-1) secretion, and postprandial hyperinsulinemia after GB is typically attributed to the combined effects of elevated glucose and GLP-1. For this review we focus on the beneficial effects of the three most commonly performed bariatric procedures, RYGB, SG, and AGB, on glucose metabolism and diabetes remission. Central to this discussion will be the extent to which the effects of surgery are mediated by GLP-1. Better understanding of these mechanisms could provide insight to development of novel therapeutic strategies for treatment of diabetes as well as refinement of surgical techniques.

Full Text

Duke Authors

Cited Authors

  • Salehi, M; D'Alessio, DA

Published Date

  • September 2014

Published In

Volume / Issue

  • 15 / 3

Start / End Page

  • 171 - 179

PubMed ID

  • 24951252

Pubmed Central ID

  • 24951252

Electronic International Standard Serial Number (EISSN)

  • 1573-2606

International Standard Serial Number (ISSN)

  • 1389-9155

Digital Object Identifier (DOI)

  • 10.1007/s11154-014-9291-y

Language

  • eng