چکیده (انگلیسی):

Purpose: Bariatric surgery is an efficient procedure for the remission of type 2 diabetes
(T2DM) from morbid obesity. However, in Asian countries, the mean body mass index
(BMI) of T2DM patients is about 25 kg/m2
. Various data on patients undergoing gastric bypass
surgery suggest that the control of T2DM after surgery occurs rapidly. We hypothesized that
even in nonobese patients with T2DM, the levels of incretin and insulin changed along with
the improvement of T2DM as a consequence of the gastric bypass.
Materials and methods: From March to December 2011, 12 nonobese patients (mean BMI;
26.2 kg/m2
) with poorly-controlled [mean glycated hemoglobin (HbA1C); 9.5%] diabetes underwent
gastric bypass surgery. Values related to diabetes, including incretin [gastric inhibitory
peptide (GIP) and glucagon-like peptide-1 (GLP-1)] levels were measured before and 1 month
after surgery. All values were measured in response to a 75 g oral glucose tolerance test
(OGTT).
Results: On average, the BMI decreased by 2.1
0.7 kg/m2
. Mean HbA1C level decreased by
1.6
2%. Oral glucose-stimulated insulin levels increased and GLP-1 levels also increased
significantly. Oral glucose-stimulated GIP levels decreased sharply.
Conclusion: Soon after gastric bypass in nonobese T2DM patients, control of T2DM is achieved.
The incretin release after oral glucose is improved. This could be a consequence of changes of
the enteroinsular axis, particularly in the incretins.