Roux-en-Y gastric bypass (RYGB) is one of the most common bariatric surgeries. The procedure induces a sustained weight loss together with a reduction in obesity-related comorbidities including type 2 diabetes.… Click to show full abstract
Roux-en-Y gastric bypass (RYGB) is one of the most common bariatric surgeries. The procedure induces a sustained weight loss together with a reduction in obesity-related comorbidities including type 2 diabetes. The effects on postprandial glucose metabolism are evident within days or weeks after surgery - before any weight loss has occurred - and are thought to be achieved by a faster passage of nutrients to the small intestine and ensuing alterations in the secretion of several gastrointestinal hormones, acceleration of glucose absorption and increased insulin secretion. Especially the remarkable increase in postprandial plasma levels of the gut-derived incretin hormone glucagon-like peptide 1 (GLP-1) - with not only a potent insulinotropic effect, but also a glucagonostatic effect - is believed to contribute to the metabolic improvements and the early remission of type 2 diabetes seen after RYGB.
               
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