Abstract

The mechanisms of type 2 diabetes (T2DM) remission after gastric bypass surgery (GBP) are unclear. Thelevels of the gut hormones incretins and their effect on insulin secretion, which is impaired in T2DM, markedlyincrease after GBP. The anatomical changes of GBP, rather than weight loss, seem to be responsible for thechanges of incretins. The objective of this proposal is to investigate the different mechanisms by which GBPand gastric banding (LAGB) affect glucose control.We wish to understand the role of weight loss versus changes in gut peptides in the short and long term inmorbidly patients with T2DM after GBP or LAGB.
AIM 1 will compare the short term effect of GBP and LAGBon incretin levels and effect after an equivalent 10 kg weight loss, testing the hypothesis that incretin levels andeffect will increase more after GBP than after LAGB.
AIM 2 will study the long-term changes in the incretinlevels and effect after oral glucose and during a multiple meal diet, before and after GBP, testing thehypothesis that mean incretin levels is greater after GBP.
AIM 3 will study the changes of insulin secretion in response to IV glucose (AIRg) and insulin sensitivity (Si),measured by the minimal model, 2 years after GBP and LAGB, testing the hypothesis that for an equivalentincrease of Si, AIRg will increase more after GBP than after LAGB.

Public Health Relevance

Gastric bypass surgery results in more weight loss and greater rates of type 2 diabetes remission thanadjustable gastric banding. This project will seek to identify factors responsible for the better effect of gastricbypass surgery. We hypothesize that some of the effects of gastric bypass may be related to change of the guthormones rather than weight loss itself. The objective of this proposal is to investigate the differentmechanisms by which these 2 surgeries affect glucose control. Results from this study will help understand themechanism of diabetes remission after weight loss surgery and help develop new treatment for severe obesityand type 2 diabetes.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
7R01DK067561-08
Application #
9044223
Study Section
Clinical and Integrative Diabetes and Obesity Study Section (CIDO)
Program Officer
Teff, Karen L
Project Start
2014-10-14
Project End
2016-08-31
Budget Start
2014-10-14
Budget End
2016-08-31
Support Year
8
Fiscal Year
2013
Total Cost
$21,184
Indirect Cost
$7,944

  Institution

Name
Columbia University (N.Y.)
Department
Type
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032

  Publications

Shah, Ankit; Levesque, Kiarra; Pierini, Esmeralda et al. (2018) Effect of sitagliptin on glucose control in type 2 diabetes mellitus after Roux-en-Y gastric bypass surgery. Diabetes Obes Metab 20:1018-1023
Laferrère, Blandine; Pattou, François (2018) Weight-Independent Mechanisms of Glucose Control After Roux-en-Y Gastric Bypass. Front Endocrinol (Lausanne) 9:530
Shah, Ankit; Laferrère, Blandine (2017) Diabetes after Bariatric Surgery. Can J Diabetes 41:401-406
Sala, Margarita; Haller, Deborah L; Laferrère, Blandine et al. (2017) Predictors of Attrition Before and After Bariatric Surgery. Obes Surg 27:548-551
Holter, Marlena M; Dutia, Roxanne; Stano, Sarah M et al. (2017) Glucose Metabolism After Gastric Banding and Gastric Bypass in Individuals With Type 2 Diabetes: Weight Loss Effect. Diabetes Care 40:7-15
Stano, Sarah; Alam, Fatima; Wu, Louis et al. (2017) Effect of meal size and texture on gastric pouch emptying and glucagon-like peptide 1 after gastric bypass surgery. Surg Obes Relat Dis 13:1975-1983
Dutia, R; Embrey, M; O'Brien, S et al. (2016) Temporal changes in bile acid levels and 12?-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes (Lond) 40:554
Laferrère, B (2016) Bariatric surgery and obesity: influence on the incretins. Int J Obes Suppl 6:S32-S36
Adams, T D; Hammoud, A O; Davidson, L E et al. (2015) Maternal and neonatal outcomes for pregnancies before and after gastric bypass surgery. Int J Obes (Lond) 39:686-94
Dutia, R; Embrey, M; O'Brien, C S et al. (2015) Temporal changes in bile acid levels and 12?-hydroxylation after Roux-en-Y gastric bypass surgery in type 2 diabetes. Int J Obes (Lond) 39:806-13

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