Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after roux-en-y gastric bypass

Meera Shah, Jennie H. Law, Francesco Micheletto, Matheni Sathananthan, Chiara Dalla Man, Claudio Cobelli, Robert A. Rizza, Michael Camilleri, Alan R. Zinsmeister, Adrian Vella

Research output: Contribution to journalArticle

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Abstract

The contribution of elevated glucagon-like peptide 1 (GLP-1) to postprandial glucose metabolism after Roux-en-Y gastric bypass (RYGB) has been the subject of uncertainty. We used exendin-9,39, a competitive antagonist of GLP-1, to examine glucose metabolism, islet hormone secretion, and gastrointestinal transit in subjects after RYGB and in matched control subjects. Subjects were studied in the presence or absence of exendin-9,39 infused at 300 pmol/kg/min. Exendin-9,39 resulted in an increase in integrated postprandial glucose concentrations post-RYGB (3.6 6 0.5 vs. 2.0 6 0.4 mol/6 h, P = 0.001). Exendin-9,39 decreased insulin concentrations (12.3 6 2.2 vs. 18.1 6 3.1 nmol/6 h, P = 0.002) and the β-Cells response to glucose (fTotal, 13 6 1 vs. 11 6 1 3 1029 min21 , P = 0.01) but did not alter the disposition index (DI). In control subjects, exendin-9,39 also increased glucose (2.2 6 0.4 vs. 1.7 6 0.3 mol/6 h, P = 0.03) without accompanying changes in insulin concentrations, resulting in an impaired DI. Post-RYGB, acceleration of stomach emptying during the first 30 min by exendin-9,39 did not alter meal appearance, and similarly, suppression of glucose production and stimulation of glucose disappearance were unaltered in RYGB subjects. These data indicate that endogenous GLP-1 has effects on glucose metabolism and on gastrointestinal motility years after RYGB. However, it remains uncertain whether this explains all of the changes after RYGB.

Original languageEnglish (US)
Pages (from-to)483-493
Number of pages11
JournalDiabetes
Volume63
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Glucagon-Like Peptide 1
Gastric Bypass
Glucose
Insulin
Gastrointestinal Transit
Gastrointestinal Motility
Uncertainty
Meals
exendin (9-39)
Stomach
Hormones

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Shah, M., Law, J. H., Micheletto, F., Sathananthan, M., Dalla Man, C., Cobelli, C., ... Vella, A. (2014). Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after roux-en-y gastric bypass. Diabetes, 63(2), 483-493. https://doi.org/10.2337/db13-0954

Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after roux-en-y gastric bypass. / Shah, Meera; Law, Jennie H.; Micheletto, Francesco; Sathananthan, Matheni; Dalla Man, Chiara; Cobelli, Claudio; Rizza, Robert A.; Camilleri, Michael; Zinsmeister, Alan R.; Vella, Adrian.

In: Diabetes, Vol. 63, No. 2, 02.2014, p. 483-493.

Research output: Contribution to journalArticle

Shah, M, Law, JH, Micheletto, F, Sathananthan, M, Dalla Man, C, Cobelli, C, Rizza, RA, Camilleri, M, Zinsmeister, AR & Vella, A 2014, 'Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after roux-en-y gastric bypass', Diabetes, vol. 63, no. 2, pp. 483-493. https://doi.org/10.2337/db13-0954
Shah M, Law JH, Micheletto F, Sathananthan M, Dalla Man C, Cobelli C et al. Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after roux-en-y gastric bypass. Diabetes. 2014 Feb;63(2):483-493. https://doi.org/10.2337/db13-0954
Shah, Meera ; Law, Jennie H. ; Micheletto, Francesco ; Sathananthan, Matheni ; Dalla Man, Chiara ; Cobelli, Claudio ; Rizza, Robert A. ; Camilleri, Michael ; Zinsmeister, Alan R. ; Vella, Adrian. / Contribution of endogenous glucagon-like peptide 1 to glucose metabolism after roux-en-y gastric bypass. In: Diabetes. 2014 ; Vol. 63, No. 2. pp. 483-493.
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