The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery (Articolo in rivista)

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  • The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery (Articolo in rivista) (literal)
Anno
  • 2011-01-01T00:00:00+01:00 (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#doi
  • 10.1210/jc.2011-0446 (literal)
Alternative label
  • Nannipieri, M.;Mari, A.;Anselmino, M.;Baldi, S.;Barsotti, E.;Guarino, D.;Camastra, S.;Bellini, R.;Berta, R.D.;Ferrannini, E (2011)
    The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery
    in The Journal of clinical endocrinology and metabolism
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Nannipieri, M.;Mari, A.;Anselmino, M.;Baldi, S.;Barsotti, E.;Guarino, D.;Camastra, S.;Bellini, R.;Berta, R.D.;Ferrannini, E (literal)
Pagina inizio
  • E1372 (literal)
Pagina fine
  • E1379 (literal)
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  • http://www.ncbi.nlm.nih.gov/pubmed/21778221 (literal)
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  • 96 (literal)
Rivista
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  • 8 (literal)
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  • 9 (literal)
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  • Scopu (literal)
  • ISI Web of Science (WoS) (literal)
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  • 1, 4, 5, 6, 7, 10: Department of Internal Medicine, University of Pisa; 2: Consiglio Nazionale delle Ricerche Institute of Biomedical Engineering, 35127 Padua, Italy; 3, 8, 9: Division of Bariatric Surgery, Santa Chiara Hospital, 56100 Pisa, Italy (literal)
Titolo
  • The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery (literal)
Abstract
  • Context: Bariatric surgery can induce remission in a high proportion of severely obese patients with type 2 diabetes mellitus (T2DM). Objective:Our objective was to investigate predictors andmechanisms of surgery-induced diabetes remission. Patients and Setting: Forty-three morbidly obese subjects (body mass index ? 45.6 5.0 kg/m2 ), 32 with T2DM and 11 nondiabetic [normal glucose tolerance (NGT)], participated at a clinical research center. Intervention: Patients underwent Roux-en-Y gastric bypass. Main Outcome Measures: Diabetes remission and ?-cell function were evaluated. Results: Subjects were tested before and 45 d and 1 yr after surgery. Weight decreased similarly in T2DM and NGT (39 kg at 1 yr, P ? 0.0001). Insulin sensitivity improved in both groups in proportion to the changes in body mass index but remained lower in T2DM than NGT (386 91 vs. 479 89 ml/min ? m2 , P ? 0.01). Based on glycosylated hemoglobin and oral glucose testing, diabetes had remitted in nine patients at 45 d and in an additional 16 at 1 yr. In T2DM, ?-cell glucose sensitivity increased early after surgery but was no further improved and still abnormal at 1 yr [median, 48 (coefficient interval, 53) pmol/min ? m2 ? mM vs. median, 100 (coefficient interval, 68) of NGT, P ? 0.001]. Baseline?-cell glucose sensitivity wasprogressivelyworsein early remitters,late remitters, and nonremitters (median, 54[coefficient interval, 50] vs. median, 22[coefficient interval, 26] vs. median, 4[coefficient interval, 10] pmol/min ? m2 ? mM) and, by logistic regression, was the only predictor of failure [odds ratio for bottom tertile ? 7.9 (95% confidence interval ? 1.2-51.9); P ? 0.03]. Conclusions: In morbid obesity, Roux-en-Y gastric bypass causes rapid and profound metabolic adaptations; insulin sensitivity improves in proportion to the weight loss, and ?-cell glucose sensitivity increases independently of weight loss. Over a period of 1 yr after surgery, diabetes remission depends on the starting degree of ?-cell dysfunction. (literal)
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