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Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans.

Publication ,  Journal Article
Salehi, M; Prigeon, RL; D'Alessio, DA
Published in: Diabetes
September 2011

OBJECTIVE: Gastric bypass (GB) surgery is associated with postprandial hyperinsulinemia, and this effect is accentuated in postsurgical patients who develop recurrent hypoglycemia. Plasma levels of the incretin glucagon-like peptide 1 (GLP-1) are dramatically increased after GB, suggesting that its action contributes to alteration in postprandial glucose regulation. The aim of this study was to establish the role of GLP-1 on insulin secretion in patients with GB. RESEARCH DESIGN AND METHODS: Twelve asymptomatic individuals with previous GB (Asym-GB), 10 matched healthy nonoperated control subjects, and 12 patients with recurrent hypoglycemia after GB (Hypo-GB) had pre- and postprandial hormone levels and insulin secretion rates (ISR) measured during a hyperglycemic clamp with either GLP-1 receptor blockade with exendin-(9-39) or saline. RESULTS: Blocking the action of GLP-1 suppressed postprandial ISR to a larger extent in Asym-GB individuals versus control subjects (33 ± 4 vs.16 ± 5%; P = 0.04). In Hypo-GB patients, GLP-1 accounted for 43 ± 4% of postprandial ISR, which was not significantly higher than that in Asym-GB subjects (P = 0.20). Glucagon was suppressed similarly by hyperglycemia in all groups but rose significantly after the meal in surgical individuals but remained suppressed in nonsurgical subjects. GLP-1 receptor blockade increased postprandial glucagon in both surgical groups. CONCLUSIONS: Increased GLP-1-stimulated insulin secretion contributes significantly to hyperinsulinism in GB subjects. However, the exaggerated effect of GLP-1 on postprandial insulin secretion in surgical subjects is not significantly different in those with and without recurrent hypoglycemia.

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Published In

Diabetes

DOI

EISSN

1939-327X

Publication Date

September 2011

Volume

60

Issue

9

Start / End Page

2308 / 2314

Location

United States

Related Subject Headings

  • Postprandial Period
  • Pancreas
  • Middle Aged
  • Male
  • Insulin Secretion
  • Insulin
  • Humans
  • Glucagon-Like Peptide 1
  • Glucagon
  • Gastric Bypass
 

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Salehi, M., Prigeon, R. L., & D’Alessio, D. A. (2011). Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans. Diabetes, 60(9), 2308–2314. https://doi.org/10.2337/db11-0203
Salehi, Marzieh, Ronald L. Prigeon, and David A. D’Alessio. “Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans.Diabetes 60, no. 9 (September 2011): 2308–14. https://doi.org/10.2337/db11-0203.
Salehi M, Prigeon RL, D’Alessio DA. Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans. Diabetes. 2011 Sep;60(9):2308–14.
Salehi, Marzieh, et al. “Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans.Diabetes, vol. 60, no. 9, Sept. 2011, pp. 2308–14. Pubmed, doi:10.2337/db11-0203.
Salehi M, Prigeon RL, D’Alessio DA. Gastric bypass surgery enhances glucagon-like peptide 1-stimulated postprandial insulin secretion in humans. Diabetes. 2011 Sep;60(9):2308–2314.

Published In

Diabetes

DOI

EISSN

1939-327X

Publication Date

September 2011

Volume

60

Issue

9

Start / End Page

2308 / 2314

Location

United States

Related Subject Headings

  • Postprandial Period
  • Pancreas
  • Middle Aged
  • Male
  • Insulin Secretion
  • Insulin
  • Humans
  • Glucagon-Like Peptide 1
  • Glucagon
  • Gastric Bypass