Background and aims: Bariatric surgery leads to significant weight loss and improvements in glucose metabolism with remission of type 2 diabetes (T2D).
The goal of this work was to study the physiological mechanisms that explained these improvements.
Methods: Fifteen morbid obese subjects (7 obese non diabetic and 8 with type 2 diabetes before the surgery) were studied before surgery by gastric bypass (RYGB), 1 month, 1 year and 8 years after surgery.
The protocol used the infusion of stable isotope tracers of glucose and glycerol [6,6-2H]-glucose and [2H5]-glycerol for the assessment of endogenous glucose production (EGP) and rate of lipolysis (RaLip) at fasting and during mixed meal test (MTT). During the meal U-[13C]-glucose per os was used for the assessment of oral glucose uptake.
Results: The patients lost a significant amount of weight that was maintained at 8 years. Moreover glycemic control was improved and all subjects were non diabetics after surgery and this was maintained after 8 years. All glucose fluxes were decreased and this explained the better glycemic control
Conclusions: Bariatric surgery by RYGB dramatically reduces body weight and improves metabolic control resulting in remission of diabetes that is maintained at 8 years after surgery.