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This is a single-site, prospective cohort study of diabetic participants undergoing Roux-en-Y gastric bypass (RYGB) at the Hospital of the University of Pennsylvania. After a screening visit to determine eligibility, participants will be studied at baseline (up to 3 weeks prior to surgery) and after surgery on postoperative days 10 +/- 3 and 90 +/- 14. We will measure the GLP-1 response following ingestion of a test meal prior to and after RYGB. Other factors that also affect glucose homeostasis will also be measured, including insulin and glucagon.
Many diabetic patients who have Roux-en-Y gastric bypass (RYGB) have rapid improvements in their blood sugars within days of their surgery, even before they have lost much weight. Changes in levels of hormones released by the small intestine as a consequence of gastric bypass may be an important factor in the rapid improvement of glycemia. One of these hormones, glucagon-like peptide-1 (GLP-1), has an important effect on insulin secretion from the pancreas and may account for the dramatic improvements in blood sugars. This study seeks to identify whether GLP-1 levels within the first 1 to 2 weeks after surgery predict whether diabetes will improve or resolve after surgery. In order to meet inclusion criteria, participants must have type 2 diabetes for less than 10 years and be scheduled to undergo gastric bypass at HUP. Hormone levels will be measured during three study visits. The first visit will occur about 2 to 3 weeks before surgery, followed by two postoperative visits (1 to 2 weeks and 3 months after surgery). Hormone levels will be measured after study participants drink about ¾ of a cup of Boost Plus over 60 minutes.
Allocation: Non-Randomized, Control: Active Control, Intervention Model: Single Group Assignment, Masking: Open Label
Mixed meal challenge
Clinical Translational Research Center
Not yet recruiting
University of Pennsylvania
Published on BioPortfolio: 2014-07-23T21:08:38-0400
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