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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
Statement of
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
RMID: 0030014451
DOI: 10.1002/oby.20791
Appears in Collections:Medicine publications

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