Incretin Physiology and Beta-cell Function Before and After Weight-loss

Incretin Physiology and Beta-cell Function Before and After Weight-loss - Effects of Long-term Weight Loss Following Laparoscopic Adjustable Gastric Banding

To evaluate the impact of laparoscopic adjustable gastric banding (LAGB) on beta-cell function, insulin sensitivity, incretin function, postprandial secretion of incretin hormones (glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)) in morbidly obese patients and to describe the pathophysiological mechanisms involved in the amelioration of glucose homeostasis during long-term weight loss.

Morbid obesity represents a serious health issue in Western countries, with a rising incidence and a strong association with increased mortality and serious co-morbidities, such as diabetes. Surgical interventions, such as laparoscopic gastric banding have been developed with the aim of providing a laparoscopic placed device that is safe and effective in generating substantial weight loss. By investigation of the incretin effect, the secretion of GIP and GLP-1, the insulin response and sensitivity and the beta-cell responsiveness to glucose in 10 obese patients without type 2 diabetes before and after laparoscopic gastric banding the aim of this project is describe the pathophysiological mechanisms involved in the amelioration of glucose homeostasis during long-term weight loss.

Inclusion Criteria:

• Caucasians without type 2 diabetes mellitus
• Normal OGTT (75 g of glucose) according to WHO's criteria
• Patients fulfilling the criteria for laparoscopic gastric banding
• Normal Hemoglobin
• Informed consent

Exclusion Criteria:

• Liver disease (ALAT > 2 x normal level)
• Nephropathy (s-creatinin > 130 µM or albuminuria)
• Relatives (parents/siblings) with T2DM
• Medical treatment witch cannot be stopped for 12 hours