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Protein and Glucose Absorption and Gastrointestinal Hormone Secretion Differ between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

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Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) induce comparable weight loss and improvements in glycemic control despite marked differences in gastrointestinal rearrangements. We hypothesized that absorption rates of oral… Click to show full abstract

Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) induce comparable weight loss and improvements in glycemic control despite marked differences in gastrointestinal rearrangements. We hypothesized that absorption rates of oral glucose and protein derived amino acids (AA) were accelerated after both procedures resulting in comparable gut hormone responses. 12 SG and 12 RYGB operated and 12 control (C) subjects carefully matched on BMI, age, sex and post-operative weight loss received primed-continuous infusions of stable isotopes of glucose, glycerol, phenylalanine (phe), tyrosine and urea combined with a 6-hour mixed meal test (400 kcal, 50E% carb, 35E% fat, 15E% protein) containing a glucose isotope and intrinsically phe labelled casein. Peak rate of appearance (Ra) of oral glucose was higher after RYGB and SG compared with C (RYGB 36±1 µmol/kg FFM/min, SG 27±1, C 22±1; p Disclosure M.S. Svane: None. K.N. Bojsen-Moller: None. C. Martinussen: None. C. Dirksen: None. S. Reitelseder: None. L. Holm: None. V.B. Kristiansen: None. G. van Hall: None. J.J. Holst: Advisory Panel; Self; Novo Nordisk A/S. Board Member; Self; Zealand Pharma A/S. Speaker9s Bureau; Self; Merck Sharp & Dohme Corp., AstraZeneca. Research Support; Self; Danish Diabetes Academy, Novo Nordisk Foundation. Other Relationship; Self; Antag Therapeutics. Other Relationship; Spouse/Partner; Antag Therapeutics. S. Madsbad: Advisory Panel; Self; AstraZeneca. Speaker9s Bureau; Self; AstraZeneca. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker9s Bureau; Self; Eli Lilly and Company, Eli Lilly and Company. Advisory Panel; Self; Merck Sharp & Dohme Corp., Sanofi-Aventis, Novo Nordisk A/S. Speaker9s Bureau; Self; Novo Nordisk A/S. Research Support; Self; Novo Nordisk A/S.

Keywords: gastric bypass; sleeve gastrectomy; self; novo nordisk; none; roux gastric

Journal Title: Diabetes
Year Published: 2018

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