Mechanisms of Diabetes Control After Weight Loss Surgery

摘要 胃旁路手术(GBP)后2型糖尿病(T2 DM)缓解的机制尚不清楚。这个 2型糖尿病患者胃肠激素胰岛素水平及其对胰岛素分泌的影响 在英镑之后增加。GBP的解剖学变化，而不是体重减轻，似乎是导致 胰岛素的变化。这项提议的目的是调查英镑通过哪些不同的机制 和胃束带(LAGB)影响血糖控制。 我们希望了解体重减轻与肠肽变化在短期和长期内的作用。 病态T2 DM患者行GBP或LAGB治疗。目标1将比较GBP和LAGB的短期效果 在相当于10公斤的体重减轻后，对胰岛素水平和效果的影响，检验了以下假设 GBP治疗后的效果比LAGB治疗后的效果更明显。目标2将研究胰岛素的长期变化 在口服葡萄糖和多餐饮食期间，GBP前后的水平和效果，测试 GBP后平均胰岛素水平更高的假说。 目的3研究静脉注射葡萄糖(AIR G)和胰岛素敏感性(SI)对胰岛素分泌的影响。 由最小模型测量，在GBP和LAGB之后2年，检验假设对于等价的 GBP后Si、AirG的升高幅度大于LAGB。

Abstract The mechanisms of type 2 diabetes (T2DM) remission after gastric bypass surgery (GBP) are unclear. The levels of the gut hormones incretins and their effect on insulin secretion, which is impaired in T2DM, markedly increase after GBP. The anatomical changes of GBP, rather than weight loss, seem to be responsible for the changes of incretins. The objective of this proposal is to investigate the different mechanisms by which GBP and 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 in morbidly patients with T2DM after GBP or LAGB. AIM 1 will compare the short term effect of GBP and LAGB on incretin levels and effect after an equivalent 10 kg weight loss, testing the hypothesis that incretin levels and effect will increase more after GBP than after LAGB. AIM 2 will study the long-term changes in the incretin levels and effect after oral glucose and during a multiple meal diet, before and after GBP, testing the hypothesis 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 equivalent increase of Si, AIRg will increase more after GBP than after LAGB.