Common Channel Length in Bypass Surgery Does Not Impact T2DM in Diabetic Zucker Rats.

Abstract

INTRODUCTION:

Metabolic surgery is known to impact glucose tolerance but the exact mechanism is still unclear. Based on recently-published data, especially the role of the hindgut may require redefinition.

METHODS:

Either a loop duodeno-jejunostomy (DJOS) with exclusion of one third of total intestinal length, a loop duodeno-ileostomy (DiOS, exclusion of two thirds), or SHAM operation was performed in 9-week-old Zucker diabetic fatty rats. One, 3, and 6 months after surgery, an oral glucose tolerance test (OGTT) and glucose-stimulated hormone analyses were conducted. Body weight was documented weekly.

RESULTS:

DJOS and DiOS animals showed significantly better glucose control in all OGTTs than the SHAM group (two-way ANOVA p < 0.0001). Body weight developed largely parallel in both intervention groups; SHAM animals had gained significantly less weight after 6 months (Mann-Whitney DJOS/DiOS vs. SHAM p < 0.05, DJOS vs. DiOS p > 0.05). Operative interventions had no impact on GLP-1 and GIP levels at any time point (Mann-Whitney p > 0.05 for all). DJOS/DiOS operations could preserve insulin production up to 6 months, while there was already a sharp decline of insulin levels in the SHAM group (Mann-Whitney: DJOS/DiOS vs. SHAM p < 0.05 for all time points). Additionally, insulin sensitivity was improved significantly 1 month postoperative in both intervention groups compared to SHAM (Mann-Whitney DJOS/DiOS vs. SHAM p < 0.05).

CONCLUSION:

The data of the current study demonstrate a sharp amelioration of glucose control after duodenal exclusion with unchanged levels of GLP-1 and GIP. Direct or delayed hindgut stimulation had no impact on glucose control in our model.

• Authors: Claudia Laessle, Sven Michelmichel, Goran Marjanovic, Simon Kuesters, Gabriel Seifert, Ulrich T Hopt, Jodok Matthias Fink
• Journal: Obesity surgery (Obes Surg) Vol. 27 Issue 8 Pg. 2090-2098 (08 2017) ISSN: 1708-0428 [Electronic] United States
• PMID: 28281233 (Publication Type: Journal Article)

Topics

• Animals
• Diabetes Mellitus, Experimental (complications, surgery)
• Diabetes Mellitus, Type 2 (complications, surgery)
• Duodenum (surgery)
• Enterostomy (adverse effects, methods)
• Gastric Bypass (adverse effects, methods)
• Glucose Tolerance Test
• Insulin Resistance
• Intestines (pathology, surgery)
• Male
• Obesity, Morbid (complications, pathology, surgery)
• Organ Size (physiology)
• Rats
• Rats, Zucker