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Roux-en Y Gastric Bypass Is Superior to Duodeno-Jejunal Bypass in Improving Glycaemic Control in Zucker Diabetic Fatty Rats |
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| Authors: | Florian Seyfried Marco Bueter Kerstin Spliethoff Alexander D Miras Kathrin Abegg Thomas A Lutz Carel W le Roux |
| Institution: | 1. Department of Investigative Medicine, Imperial College London, London, UK 2. Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Wuerzburg, Germany 3. Department of Surgery, University of Zürich, Zürich, Switzerland 4. Zurich Center of Integrative Human Physiology, University of Zurich, Zürich, Switzerland 5. Institute of Veterinary Physiology, University of Zürich, Zürich, Switzerland 6. Institute of Laboratory Animal Sciences, University of Zürich, Zürich, Switzerland 7. Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland 8. Experimental Pathology, UCD Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland |
| Abstract: | BackgroundWhilst weight loss results in many beneficial metabolic consequences, the immediate improvement in glycaemia after Roux-en-Y Gastric bypass (RYGB) remains intriguing. Duodenal jejunal bypass (DJB) induces similar glycaemic effects, while not affecting calorie intake or weight loss. We studied diabetic ZDFfa/fa rats to compare the effects of DJB and RYGB operations on glycaemia.MethodsMale ZDFfa/fa rats, aged 12 weeks underwent RYGB, DJB or sham operations. Unoperated ZDFfa/fa and ZDFfa/+were used as controls. Body weight, food intake, fasting glucose, insulin and gut hormones were measured at baseline and on postoperative days 2, 10 and 35. An oral glucose tolerance test (OGTT) was performed on days 12 and 26.ResultsDJB had similar food intake and body weight to sham-operated and unoperated control ZDFfa/fa rats (p?=?NS), but had lower fasting glucose (p?p?fa/fa rats, while RYGB with normalized glycaemia reduced the physiological requirement for raised fasting insulin.ConclusionsBypassing the proximal small bowel with the DJB has mild to moderate body weight independent effects on glucose homeostasis and preservation of fasting insulin levels in the medium term. These effects might be further amplified by the additional anatomical and physiological changes after RYGB |
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