PMID- 19372197
OWN - NLM
STAT- MEDLINE
DCOM- 20090618
LR  - 20220318
IS  - 1945-7170 (Electronic)
IS  - 0013-7227 (Linking)
VI  - 150
IP  - 6
DP  - 2009 Jun
TI  - Minireview: Hormonal and metabolic mechanisms of diabetes remission after 
      gastrointestinal surgery.
PG  - 2518-25
LID - 10.1210/en.2009-0367 [doi]
AB  - Bariatric surgery is the most effective available treatment for obesity. The most 
      frequently performed operation, Roux-en-Y gastric bypass (RYGB), causes profound 
      weight loss and ameliorates obesity-related comorbid conditions, especially type 
      2 diabetes mellitus (T2DM). Approximately 84% of diabetic patients experience 
      complete remission of T2DM after undergoing RYGB, often before significant weight 
      reduction. The rapid time course and disproportional degree of T2DM improvement 
      after RYGB compared with equivalent weight loss from other interventions suggest 
      surgery-specific, weight-independent effects on glucose homeostasis. Potential 
      mechanisms underlying the direct antidiabetic impact of RYGB include enhanced 
      nutrient stimulation of lower intestinal hormones (e.g. glucagon-like peptide-1), 
      altered physiology from excluding ingested nutrients from the upper intestine, 
      compromised ghrelin secretion, modulations of intestinal nutrient sensing and 
      regulation of insulin sensitivity, and other changes yet to be fully 
      characterized. Research aimed at determining the relative importance of these 
      effects and identifying additional mechanisms promises not only to improve 
      surgical design but also to identify novel targets for diabetes medications.
FAU - Thaler, Joshua P
AU  - Thaler JP
AD  - Department of Medicine, Division of Metabolism, Center of Excellence and Veterans 
      Affairs, Puget Sound Health Care System, University of Washington, Seattle, 
      Washington 98195, USA.
FAU - Cummings, David E
AU  - Cummings DE
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20090416
PL  - United States
TA  - Endocrinology
JT  - Endocrinology
JID - 0375040
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Bariatric Surgery/*methods
MH  - Diabetes Mellitus, Type 2/*metabolism
MH  - Glucose/metabolism
MH  - Homeostasis/physiology
MH  - Humans
MH  - Obesity/*metabolism/surgery
MH  - Remission Induction
RF  - 75
EDAT- 2009/04/18 09:00
MHDA- 2009/06/19 09:00
CRDT- 2009/04/18 09:00
PHST- 2009/04/18 09:00 [entrez]
PHST- 2009/04/18 09:00 [pubmed]
PHST- 2009/06/19 09:00 [medline]
AID - en.2009-0367 [pii]
AID - 10.1210/en.2009-0367 [doi]
PST - ppublish
SO  - Endocrinology. 2009 Jun;150(6):2518-25. doi: 10.1210/en.2009-0367. Epub 2009 Apr 
      16.