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https://hdl.handle.net/2440/87428
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Type: | Journal article |
Title: | Rapid gastric and intestinal transit is a major determinant of changes in blood glucose, intestinal hormones, glucose absorption and postprandial symptoms after gastric bypass |
Author: | Nguyen, N. Debreceni, T. Bambrick, J. Bellon, M. Wishart, J. Standfield, S. Rayner, C. Horowitz, M. |
Citation: | Obesity, 2014; 22(9):2003-2009 |
Publisher: | Wiley |
Issue Date: | 2014 |
ISSN: | 1930-7381 1930-739X |
Statement of Responsibility: | Nam Q. Nguyen, Tamara L. Debreceni, Jenna E. Bambrick, Max Bellon, Judith Wishart, Scott Standfield, Chris K. Rayner and Michael Horowitz |
Abstract: | OBJECTIVE: To evaluate the effect of modulating pouch emptying (PE) and SI transit of glucose after Roux-en-Y gastric bypass (RYGB) on blood glucose, incretin hormones, glucose absorption and gastrointestinal (GI) symptoms. METHODS: Ten RYGB patients were studied twice in random order, receiving either a 150 ml glucose drink (200 kcal) or the same solution infused into the proximal Roux-limb at 4 kcal/min. Data were compared with 10 healthy volunteers who received a 4 kcal/min duodenal infusion. PE, cecal arrival time (CAT), blood glucose, plasma 3-O-methylglucose (3-OMG), insulin, glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide-1 (GLP-1), and GI symptoms were measured. RESULTS: In RYGB subjects, the glucose drink emptied very rapidly (PE t50 = 3 ± 1 min) and intestinal glucose infusion was associated with higher blood glucose and plasma 3-OMG, but lower plasma GLP-1, GIP, insulin, and GI symptoms than oral glucose (all P < 0.001), and comparable to volunteers. In RYGB subjects, CAT correlated inversely with peak GLP-1 (r = -0.73, P = 0.01), and plasma 3-OMG correlated tightly blood glucose (r = 0.94, P < 0.0001). CONCLUSIONS: After RYGB, reducing intestinal glucose delivery to 4 kcal/min is associated with higher blood glucose, greater glucose absorption, lower incretin responses, and less GI symptoms, supporting rapid transit contribution to the exaggerated incretin responses and "dumping symptoms". |
Keywords: | Humans Dumping Syndrome Gastrointestinal Hormones Insulin Glucose Blood Glucose Gastrointestinal Transit Gastric Bypass Intestinal Absorption Postprandial Period Time Factors Adult Middle Aged Female Male |
Rights: | © 2014 The Obesity Society |
DOI: | 10.1002/oby.20791 |
Published version: | http://dx.doi.org/10.1002/oby.20791 |
Appears in Collections: | Aurora harvest 2 Medicine publications |
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