Mechanisms of Diabetes Control After Weight Loss Surgery

6-摘要- 胃旁路手术后2型糖尿病(T2 DM)缓解的机制有 不清楚。胃肠激素胰岛素水平及其对胰岛素分泌的影响 T2 DM时受损，GBP后明显升高。GBP的解剖学变化，而不是 比体重减轻，似乎要对胰岛素的变化负责。这样做的目的是 建议研究GBP和胃束带(GB)的不同机制 影响血糖控制。 我们希望了解体重减轻与肠道多肽变化在短期和短期内的作用 长期患病的T2 DM患者随机分为GBP或GB。 目的1比较GBP和GB对胰岛素水平和疗效的短期影响 在减掉相当于10公斤的体重后，测试胰岛素水平和效果的假设 在GBP之后将比GB之后增加更多。 目的2研究口服葡萄糖后胰岛素水平的长期变化及其作用。 在24小时多餐饮食期间，在GBP和GB之前和两年后，测试 GBP后平均INT水平高于GB后的假说。 目的3研究静脉注射葡萄糖(AirG)后胰岛素分泌的变化 最小模型测量的胰岛素敏感性(Si)，在GBP和GB后2年， 检验假设，对于相同的Si增加，airG将在 GBP高于GB之后。

6-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 (GB) 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 randomized to GBP or GB. AIM 1 will compare the short term effect of GBP and GB 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 GB. AIM 2 will study the long-term changes in the incretin levels and effect after oral glucose and during a 24-h multiple meal diet, before and 2 years after GBP and GB, testing the hypothesis that mean incretin levels is greater after GBP than after GB. 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 GB, testing the hypothesis that for an equivalent increase of Si, AIRg will increase more after GBP than after GB.