MiPsummer Programme pdf - Mitochondrial Physiology Society

78
Abstract # 46
INSULIN SENSITIVITY BEFORE AND AFTER GASTRIC BYPASS IN TYPE 2
DIABETES PATIENTS AND NORMAL GLUCOSE TOLERANCE SUBJECTS.
Hansen M.¹, Lund M.¹², Helge J.W.¹, Dela F.¹
1: University of Copenhagen, Denmark.
2: Koege Hospital, Department of Surgery, Denmark.
Introduction
Gastric bypass surgery (GBP) is known to bring 75-80% of type 2 diabetes patients into remission
shortly after their operation.
We studied insulin sensitivity and body composition before and after GBP in morbidly obese
patients with type 2 diabetes (DM2) and patients with normal glucose tolerance (NGT).
The aim was to determine how insulin sensitivity is affected by uncontrolled weight loss before
operation and resulting from GBP.
Methods
11 patients (7Female/4Male, 6NGT/5DM2) were recruited. Patients were studied 3 times: At
baseline (A); after 10-12% weight loss by diet (before surgery) (B); and 4 months post surgery (C).
Body composition was measured by Dual X-ray Energy Absorption (DXA) and peripheral insulin
sensitivity by hyperinsulinemic (80mU/m²/min), euglycemic clamp.
Results
In the NGT there was no difference in GIR/FFM from A-B and B-C (p>0,05) and in spite of a
weight loss (-27.5±2kg) from A-C, GIR/FFM did not increase (11.0±0.9 vs. 13.5±1.3
mg/min/kgFFM (p=0.07)).
In DM2 GIR/FFM did not change from A-B (4.5±0.5 vs. 6.4±1.0 mg/min/kgFFM (p>0.05)) but
from B-C (6.4±1.0 vs. 9.2±0.9 mg/min/kgFFM (p=0.02)) and A-C (4.4±0.5 vs. 9.2±0.9
mg/min/kgFFM (p=0.002)) GIR/FFM increased significantly.
The size of weight loss in NGT vs. DM2 from A-B (5.7±1.0 vs. 5.2±1.0 kg) and B-C (21.8±1.0 vs.
22.8±3.0 kg ) was similar (p>0.05).
Conclusion
GBP does not improve GIR/FFM in obese patients without DM2; most likely due to initially
preserved insulin sensitivity.
A minor (diet induced) weight loss does not improve GIR/FFM in DM2, while a more massive
GBP induced weight loss improves peripheral insulin sensitivity.