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Open Access 01-02-2020 | Insulins | Original Article

Rapid changes in neuroendocrine regulation may contribute to reversal of type 2 diabetes after gastric bypass surgery

Authors: Petros Katsogiannos, Prasad G. Kamble, Urban Wiklund, Magnus Sundbom, Daniel Espes, Ulf Hammar, F. Anders Karlsson, Maria J. Pereira, Jan W. Eriksson

Published in: Endocrine | Issue 2/2020

Abstract

Objective

To explore the role of hormones and the autonomic nervous system in the rapid remission of diabetes after Roux-en-Y Gastric Bypass (RYGB).

Research design and methods

Nineteen obese patients with type 2 diabetes, 7 M/12 F, were randomized (2:1) to RYGB or standard-of-care medical treatment (control). At baseline and 4 and 24 weeks post surgery, fasting blood sampling, OGTT, intravenous arginine challenge, and heart-rate variability (HRV) assessments were performed.

Results

At both 4 and 24 weeks post-RYGB the following effects were found: arginine-stimulated insulin secretion was reduced. GLP-1, GIP, and glucagon rise during OGTT was enhanced. IGF-1 and GH levels increased. In addition, total HRV and spectral components P_LF (power of low frequency) and P_HF (power of high frequency) increased. At 4 weeks, morning cortisol was lower than baseline and 24 weeks. At 24 weeks, NEFA levels during OGTT, and the P_LF/P_HF ratio decreased. None of these changes were seen in the control group.

Conclusions

There were rapid changes within 4 weeks after RYGB: signs of enhanced parasympathetic nerve activity, reduced morning cortisol, and enhanced incretin and glucagon responses to glucose. The findings suggest that neurohormonal mechanisms can contribute to the rapid improvement of insulin resistance and glycemia following RYGB in type 2 diabetes.

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Title: Rapid changes in neuroendocrine regulation may contribute to reversal of type 2 diabetes after gastric bypass surgery
Authors: Petros Katsogiannos
Prasad G. Kamble
Urban Wiklund
Magnus Sundbom
Daniel Espes
Ulf Hammar
F. Anders Karlsson
Maria J. Pereira
Jan W. Eriksson
Publication date: 01-02-2020
Publisher: Springer US
Keywords: Insulins
Insulins
Type 2 Diabetes
Published in: Endocrine / Issue 2/2020
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-020-02203-w

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Rapid changes in neuroendocrine regulation may contribute to reversal of type 2 diabetes after gastric bypass surgery

Abstract

Objective

Research design and methods

Results

Conclusions

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Abstract

Objective

Research design and methods

Results

Conclusions

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