PMID- 23001770
OWN - NLM
STAT- MEDLINE
DCOM- 20130509
LR  - 20211021
IS  - 1534-6242 (Electronic)
IS  - 1523-3804 (Linking)
VI  - 14
IP  - 6
DP  - 2012 Dec
TI  - The effect of gastrointestinal surgery on insulin resistance and insulin 
      secretion.
PG  - 624-30
LID - 10.1007/s11883-012-0284-6 [doi]
AB  - Diabesity is a term often used to indicate the association of type-2 diabetes 
      mellitus (T2DM) with obesity; the prevalence of both conditions is rapidly 
      increasing worldwide and has reached epidemic proportions. Insulin resistance 
      represents the major determinant of T2DM, which becomes manifest once relative 
      beta-cell failure ensues and insulin secretion is no longer sufficient to compensate 
      for insulin resistance. In recent years, gastrointestinal surgery has emerged as 
      the most effective option for the treatment of obesity and diabetes, with level-1 
      evidence of diabetes remission. Restrictive gastric operations such as gastric 
      banding can improve insulin resistance in proportion to weight loss, while 
      gastrointestinal bypass procedures, such as roux-en-y gastric-bypass (RYGB) and 
      biliopancreatic diversion (BPD), can improve glucose homeostasis even before a 
      significant weight loss is reached, suggesting weight-independent mechanisms of 
      action. Studies comparing RYGB to BPD show that RYGB primarily enhances insulin 
      secretion and reduces hepatic glucose output, whereas BPD rapidly improves 
      glycemia primarily through the normalization of insulin sensitivity. Given the 
      fact that BPD involves a significantly longer bypass of the proximal intestine 
      than RYGB, these data suggest that the exclusion of a greater length of small 
      bowel from the transit of food may cause broader and more profound influence on 
      insulin sensitivity.
FAU - Castagneto, Marco
AU  - Castagneto M
AD  - Department of Surgery, Catholic University of Rome, Largo A. Gemelli 8, 00168 
      Rome, Italy.
FAU - Mingrone, Geltrude
AU  - Mingrone G
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Atheroscler Rep
JT  - Current atherosclerosis reports
JID - 100897685
RN  - 0 (Insulin)
SB  - IM
MH  - Bariatric Surgery/*methods
MH  - Diabetes Mellitus, Type 2/*surgery
MH  - Humans
MH  - Insulin/*metabolism
MH  - Insulin Resistance/*physiology
MH  - Insulin Secretion
MH  - Obesity/*surgery
MH  - Weight Loss/physiology
EDAT- 2012/09/25 06:00
MHDA- 2013/05/10 06:00
CRDT- 2012/09/25 06:00
PHST- 2012/09/25 06:00 [entrez]
PHST- 2012/09/25 06:00 [pubmed]
PHST- 2013/05/10 06:00 [medline]
AID - 10.1007/s11883-012-0284-6 [doi]
PST - ppublish
SO  - Curr Atheroscler Rep. 2012 Dec;14(6):624-30. doi: 10.1007/s11883-012-0284-6.