Early changes in glucose, insulin, C-peptide and GLP-1 levels after test meal in obese patients after gastric bypass surgery

Dragan Micic; Snezana Polovina; Mirjana Sumarac-Dumanovic; Goran Cvijovic; Svetlana Ignjatovic; Marijana Dajak; Dusan Micic; Danica Pejkovic; Jelena Milin; Danka Jeremic

doi:10.1530/endoabs.32.P743

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Endocrine Abstracts (2013) 32 P743 | DOI: 10.1530/endoabs.32.P743

ECE2013 Poster Presentations Obesity (65 abstracts)

Early changes in glucose, insulin, C-peptide and GLP-1 levels after test meal in obese patients after gastric bypass surgery

Dragan Micic , Snezana Polovina , Mirjana Sumarac-Dumanovic , Goran Cvijovic , Svetlana Ignjatovic , Marijana Dajak , Dusan Micic , Danica Pejkovic , Jelena Milin & Danka Jeremic

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Clinical Center of Serbia, Belgrade, Serbia.

Introduction: Various hypothesis exist about the mechanism of changes in glucose control and insulin sensitivity after bariatric surgery.

Description of methods/design: The aim of our study was to determine glucose, insulin, C-peptide and GLP-1 levels after test meal (Fresubin drink a 200 ml given at 0 min; 200 kcal, 15% protein, 30% fat and 55% carbohydrate) before (day 0) and 5 days after gastric bypass surgery in a 22 obese patients (age: 36.22±12.66; BMI: 44.60±4.31 kg/m²). Glycaemia (mmol/l; glucose oxidase), insulin (ECLIA, Roche Diagnostics, pmol/l), C-peptide (ECLIA, Roche Diagnostics, pmol/l) and GLP-1 (active 7–36) (pM/l; ELISA, ALPCO Diagnostics) were determined in two separate days in 0, 15, 30, 45, 60, 90 and 120 min.

Results: There were no significant difference between areas under the glucose curve (X±S.D.) (645.562±20.545 vs 621.600±24.07 mmol/l per min; P=0.304) and under the C-Peptide curve (293 074.125±23 539.975 vs 267 750.375±19 685.409 pmol/l per min; P=0.317) while there was significantly lower area under the insulin curve in day 5 (38 263.075±6079.509 vs 23 539.875±2571.388 pmol/l per min; P=0.032). There was significant increase in area under the GLP-1 curve in day 5 (163.00±73.61 vs 861.94±251.22 pmol/l per min; P<0.05).

Conclusion: In conclusion, insulin response after test meal is significantly decreased after gastric bypass surgery after 5 days without significant difference in glucose response, indicating early improvement in insulin sensitivity. The significant improvement in GLP-1 response after test meal among patients after gastric bypass surgery may be responsible for the metabolic effects of bariatric surgery, especially on glucose homeostasis.