Mechanisms of Diabetes Control After Weight Loss Surgery

摘要 胃旁路手术（GBP）后2型糖尿病（T2DM）缓解的机制尚不清楚。的 肠激素肠促胰岛素水平及其对胰岛素分泌的影响，在T2DM中受损， 英镑上涨后。GBP的解剖学变化，而不是体重减轻，似乎是造成GBP的原因。 肠促胰岛素的变化。本建议的目的是调查不同的机制， 和胃束带术（LAGB）影响血糖控制。 我们希望了解体重减轻与肠道肽变化在短期和长期内的作用， GBP或LAGB后的T2DM病态患者。AIM 1将比较GBP和LAGB的短期效果 对肠促胰岛素水平和等效10 kg体重减轻后的效果的影响，检验肠促胰岛素水平和 GBP后的效应比LAGB后的效应更大。AIM 2将研究肠促胰岛素的长期变化， 水平和效果后，口服葡萄糖和在多餐饮食，之前和之后的GBP，测试 假设GBP后平均肠促胰岛素水平更高。 目的3：研究静脉葡萄糖（AIRg）和胰岛素敏感性（Si）对胰岛素分泌的影响， 通过最小模型测量，GBP和LAGB后2年，检验假设， 随着Si含量的增加，GBP后AIRg的增加幅度大于LAGB后。

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.