Abstract
Improvement in Type 2 diabetes is seen in 80-98% of obese diabetic patients who undergo gastric bypass or bilio-pancreatic diversion. This improvement is evident early after the operation before significant weight loss has occurred. Although numerous teams have extensively studied the physiology of this early post-bypass amelioration of type 2 diabetes, the exact mechanism of diabetes remission remains unclear. Studies have focused on changes in the entero-insular axis, which is mediated in part by the interaction of insulinotropic hormones GIP and GIP 1 on the beta islet cells of the pancreas. Other mechanisms which have been postulated focus on the adipo-insular axis; the actions of adiponectin and leptin seem to have an important role in insulin resistance but their action is weight-loss dependent. Post-operative caloric restriction may also contribute to the early resolution of type 2 diabetes observed after gastric bypass and bilio- pancreatic diversion.
Translated title of the contribution | Early improvement in type 2 diabetes in obese patients following gastric bypass and bilio-pancreatic diversion: The role of the entero-insular axis |
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Original language | French |
Pages (from-to) | 549-555 |
Number of pages | 7 |
Journal | Journal de Chirurgie |
Volume | 145 |
Issue number | 6 |
DOIs | |
State | Published - 2008 |
Keywords
- Bilio pancreatic diversion
- Entero insular axis
- GLP-1
- Gut peptides
- Incretin
- Obesity
- Type 2 diabetes
ASJC Scopus subject areas
- Surgery