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Improved Beta-cell Function with Gastric Bypass or Gastric Banding

Both laparoscopic gastric banding and Roux-en-Y bypass surgery improved beta-cell function and insulin sensitivity….

Researchers examined 20 consecutive, eligible patients who were scheduled to undergo Roux-en-Y (RYGB; n=10) or laparoscopic adjustable gastric banding (LAGB; n=10) at Barnes-Jewish Hospital in St. Louis, Missouri. The patients completed body composition analyses, hyperinsulinemic-euglycemic clamp procedure and a mixed-meal metabolic study prior to gastric surgery and following a 20% surgery-induced weight loss, the researchers wrote.

Patients in the LAGB group lost 19.3% of their body weight by 22 weeks, and patients in the RYGB group lost 20.1% of their body weight by 16 weeks after surgery.

"All study subjects were insulin resistant, based on a HOMA-IR value greater than 2.5, but none had type 2 diabetes. Studying subjects without type 2 diabetes allowed us to avoid the confounding effects of differences in baseline glycemic control, glucose toxicity, and changes in diabetes medications on our metabolic outcomes measures," the researchers wrote.

These similar results were reportedly beneficial. However, researchers said that data do not support clinically meaningful weight loss-independent effects of RYGB surgery on beta-cell function and insulin sensitivity in obese patients without diabetes.

They suggest further research to determine if the findings apply to those with type 2 diabetes who are also obese.

Bradley D. J Clin Invest. 2012; doi: 10.1172/JCI64895.