Role of vagal activation in postprandial glucose metabolism after gastric bypass in individuals with and without hypoglycaemia

Diabetes, Obesity & Metabolism
Marzieh SalehiDavid D'Alessio

Abstract

Patients who have undergone gastric bypass surgery (GB) have enhanced postprandial hyperinsulinaemia and a greater incretin effect is apparent. In the present study, we sought to determine the effect of vagal activation, a neural component of the enteroinsular axis, on postprandial glucose metabolism in patients with and without hypoglycaemia after GB. Seven patients with documented post-GB hypoglycaemia, seven asymptomatic patients without hypoglycaemia post-GB, and 10 weight-matched non-surgical controls with normal glucose tolerance were recruited. Blood glucose, and islet hormone and incretin secretion were compared during mixed meal tolerance tests (MMTs) with and without prior sham-feeding on two separate days. Sham feeding preceding the MMT caused a more rapid increase in prandial blood glucose levels but lowered overall glycaemia in all three groups (P < 0.05). Sham feeding had a similar effect to increase early (P < 0.05), but not overall, meal-induced insulin secretion in the three groups. Prandial glucagon concentrations were significantly greater in the GB groups, and sham feeding accentuated this response (P < 0.05). The effect of vagal activation on prandial glucose and islet-cell function is preserved in patients...Continue Reading

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Mar 13, 2014·The Journal of Clinical Endocrinology and Metabolism·Marzieh SalehiDavid A D'Alessio
Feb 25, 2018·Trends in Endocrinology and Metabolism : TEM·Mohammed K HankirMichael A Cowley

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Citations

Jan 12, 2021·Frontiers in Endocrinology·Carolina B LobatoMariana P Monteiro

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