Glucose metabolism and production of incretins in patients with obesity and type 2 diabetes mellitus after Biliopancreatic bypass surgery in the modification of Hess-Marceau the early stages of postoperative monitoring

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Introduction: a significant improvement was shown in metabolic control at the early stages after BPD, which was associated with GLP-1 and was regardless of weight loss.

Aim: to study the secretion of GLP-1, GIP, insulin and glucagon and their relationship to the parameters of the carbohydrate metabolism among patients with obesity and type 2 diabetes before and 3 months after BPD.

Materials and Methods: the check-up involved 22 patients with obesity (BMI 50.1 [41.3; 53.8] kg/m²) and type 2 diabetes. Determined: glucose, HbA1c, insulin, glucagon, GLP-1, GIP.

Results: after the surgery for weight loss of 15.8% was showed a reduction of fasting and postprandial glycemia, a reduction of AUCglucose, HbA1c, НОМА-IR and hyperinsulinemia. The secretion of GLP-1 with a peak at 30' (test with a standard breakfast) increased, AUCGLP-1 – to 1.8-fold, the basal secretion of GIP – almost 2-fold and AUCGIP – to 1.7-fold; decreased of a secretion of glucagon with a minimum at 60' and AUCglucagon. A negative correlation was revealed between GIP and glucagon, AUCglucose and AUCglucagon; a positive correlation was revealed between GLP-1 and insulin. The weight loss was accompanied by an inversely proportional increase of GLP-1.

Conclusion: More than 90% of the surveyed patients achieved a satisfactory glycemic control as early as 3 months after BPD. The significant improvement of the parameters of the carbohydrate metabolism was associated with elevated levels of GLP-1 and this improvement does not depend of weight loss. 

About the authors

Ivan Ivanovich Dedov

Endocrinology Research Centre


Russian Federation MD, Ph.D, academician of the Russian Academy of Sciences, Director

Ekaterina Anatol'evna Troshina

Endocrinology Research Centre


Russian Federation MD, Ph.D. Professor, Head of the  Therapy Department with a group of obesity

Ekaterina Vladimirovna Ershova

Endocrinology Research Centre

Author for correspondence.

Russian Federation researcher at the the  Therapy Department with a group of obesity

Yuriy Ivanovich Yashkov

Center of Endosurgery and Lithotripsy


Russian Federation MD, Ph.D. Professor, surgeon. President of the European Federation of obesity surgery and metabolic disorders (IFSO-EU Chapter) in 2012-2014


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Copyright (c) 2015 Дедов И.И., Трошина Е.А., Ершова Е.В., Яшков Ю.И.

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