| Diabetes resolution and hyperinsulinaemia after metabolic Roux-en-Y gastric bypass. | |
| | |
MedLine Citation:
|
PMID: 20880129 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
The global prevalence of type 2 diabetes mellitus and impaired glucose metabolism continues to rise in conjunction with the pandemic of obesity. The metabolic Roux-en-Y gastric bypass operation offers the successful resolution of diabetes in addition to sustained weight loss and excellent long-term outcomes in morbidly obese individuals. The procedure consists of the physiological BRAVE effects: (i) Bile flow alteration; (ii) Reduction of gastric size; (iii) Anatomical gut rearrangement and altered flow of nutrients; (iv) Vagal manipulation and (v) Enteric gut hormone modulation. This operation provides anti-diabetic effects through decreasing insulin resistance and increasing the efficiency of insulin secretion. These metabolic outcomes are achieved through weight-independent and weight-dependent mechanisms. These include the foregut, midgut and hindgut mechanisms, decreased inflammation, fat, adipokine and bile metabolism, metabolic modulation, shifts in gut microbial composition and intestinal gluconeogenesis. In a small minority of patients, gastric bypass results in hyperinsulinaemic hypoglycaemia that may lead to nesidioblastosis (pancreatic beta-cell hypertrophy with islet hyperplasia). Elucidating the precise metabolic mechanisms of diabetes resolution and hyperinsulinaemia after surgery can lead to improved operations and disease-specific procedures including 'diabetes surgery'. It can also improve our understanding of diabetes pathogenesis that may provide novel strategies for the management of metabolic syndrome and impaired glucose metabolism. |
| | |
Authors:
|
H Ashrafian; T Athanasiou; J V Li; M Bueter; K Ahmed; K Nagpal; E Holmes; A Darzi; S R Bloom |
Related Documents
:
|
6703649 - Effects of fenugreek seeds on endocrine pancreatic secretions in dogs. 2076799 - Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. 1442369 - The use of isophane insulin for the control of diabetes mellitus in dogs. 2253919 - Pancreatic secretory trypsin inhibitor in gastrointestinal mucosa and gastric juice. 16110219 - Insulin-induced hypoglycemia stimulates gastric vagal activity and motor function witho... 11394539 - Suprarenal intraarterial infusion of alloxan and streptozotocin during balloon occlusio... 17976619 - Long-term, topical insulin administration increases the severity of retinal vascular pa... 17510699 - Type 1 diabetes: exercise and hypoglycemia. 12917799 - Association between diabetes type 1 and dqb1 alleles in a case-control study conducted ... |
Publication Detail:
|
Type: Journal Article Date: 2010-09-29 |
Journal Detail:
|
Title: Obesity reviews : an official journal of the International Association for the Study of Obesity Volume: 12 ISSN: 1467-789X ISO Abbreviation: Obes Rev Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-04-19 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100897395 Medline TA: Obes Rev Country: England |
Other Details:
|
Languages: eng Pagination: e257-72 Citation Subset: IM |
Copyright Information:
|
© 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity. |
Affiliation:
|
The Department of Surgery and Cancer, Imperial College London, London, UK Section of Investigative Medicine, Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Imperial College London, London, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Preventing excessive gestational weight gain: a systematic review of interventions.
Next Document: 'Mohs surgery of the prostate': the utility of in situ frozen section analysis during robotic prosta...