We know that patients lose a great deal of weight after bariatric surgery. Often times some of the weight comes off fast in the beginning and then slowly after that. More importantly these patients have a quick resolution of hyperglycemia and improvement in fasting, post prandial and hemoglobin A1c readings. It is very simple to explain the weight loss because food consumption drops significantly after the banding or reduction, but glucose readings are a different story. In this month’s feature article we look at how bariatric surgery increases GLP-1 levels and how this increase leads to such a rapid and pronounced effect on glucose readings.