Obesity Clinical Trial
Gastric bypass surgery induces remission of diabetes within days after surgery, before significant weight loss. The aim of the study is to examine whether improved insulin sensitivity of muscle and liver contributes to the immediate diabetes resolution.
Obesity has become a severe epidemic globally. With the rapid increase in obesity comes a
pronounced rise in obesity-related disorders, especially type 2 diabetes. Weight loss
achieved through lifestyle changes improves diabetes, but is very difficult to maintain over
time. In contrast, Roux-en-Y gastric bypass (RYGB) surgery can induce long-term weight loss
and remission of diabetes. Surprisingly, the resolution of type 2 diabetes occurs within
days after surgery and before significant weight loss. The resolution of diabetes must
therefore be explained by a response to the surgical alterations of the stomach and
intestines: restriction in gastric volume and bypass of the stomach, duodenum and proximal
jejunum.
Severe insulin resistance in muscle and liver is the common defect in obesity and type 2
diabetes and may be improved or even reversed shortly after the operation. The aim of this
study is to examine the acute changes in insulin sensitivity of muscle and liver by using
hyperinsulinaemic euglycaemic clamp combined with glucose tracer to assess hepatic glucose
production. Insulin signaling pathways will be studied in biopsies from muscle and
subcutaneous fat as to explain the molecular basis of the changes in insulin sensitivity
after RYGB.
Insulin secretion will be evaluated in response to oral glucose as well as iv
glucose-glucagon.
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Observational Model: Case Control, Time Perspective: Prospective
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