Early glycemic control and incretin improvement after gastric bypass: the role of oral and gastrostomy route

Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery
Gustavo FernandesRoberto de Cleva

Abstract

Patients with obesity have a suppressed incretin effect and a consequent imbalance of glycemic homeostasis. Several studies have shown improved type 2 diabetes after Roux-en-Y gastric bypass (RYGB). The mechanisms of early action are linked to caloric restriction, improvement of insulin resistance, pancreatic beta cell function, and the incretin effect of glycogen-like protein 1 and gastric inhibitory polypeptide, but reported data are conflicting. The objective of this study was to evaluate glycemic metabolism, including the oral glucose tolerance test and enterohormonal profile in the early postoperative period in severely obese patients who underwent RYGB with gastrostomy, comparing the preoperative supply of a standard bolus of nutrient against the postoperative administration through an oral and a gastrostomy route. Clinics Hospital of University of São Paulo, Brazil. Eleven patients with obesity and diabetes underwent RYGB with a gastrostomy performed in the excluded gastric remnant. Patients were given preoperative assessments of glycemic and enterohormone profiles and an oral glucose tolerance test; these were compared with early postoperative assessments after oral and gastrostomy route administrations. The mean preope...Continue Reading

Citations

Jul 28, 2019·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·Spyridon N KarrasKalliopi Kotsa
Jan 13, 2022·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Andressa Bressan MalafaiaBruno Luiz Ariede

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