Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Short Communication
  • Published:

Intact cross-talk between insulin secretion and insulin action after postgastroplasty recovery of ideal body weight in severely obese patients

International Journal of Obesity volume 28, pages 821–823 (2004)Cite this article

Abstract

Most reports investigating the hormonal and metabolic effects of bariatric surgery studied obese subjects after partial weight loss only. Nevertheless, all studies showed significant improvements of insulin secretion, action, clearance and inhibition of its own secretion, although the parallel kinetics of all these changes remained questionable. Using the intravenous glucose tolerance test, we demonstrated a full normalization of insulin secretion, action on glucose metabolism and clearance in eight obese women who recovered and maintained ideal body weight following gastroplasty. Reciprocal changes were observed between postglucose acute insulin secretion and insulin-mediated glucose disposal so that the so-called disposition index (product of these two variables) remained unchanged after vs before gastroplasty in those individuals with normal glucose tolerance. These favourable results should encourage obtaining a drastic and sustained weight loss in patients with severe obesity at risk of developing type II diabetes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP . The continuing epidemics of obesity and diabetes in the United States. JAMA 2001; 286: 1195–2000.

    Article  CAS  PubMed  Google Scholar 

  2. Scheen AJ, Paquot N, Letiexhe M, Paolisso G, Castillo MJ, Lefèbvre PJ . Glucose metabolism in obese subjects: lessons from OGTT, IVGTT, and clamp studies. Int J Obes Relat Metab Disord 1995; 19 (Suppl): S14–S20.

    CAS  PubMed  Google Scholar 

  3. Scheen AJ . Current management strategies for coexisting diabetes mellitus and obesity. Drugs 2003; 63: 1165–1184.

    Article  CAS  PubMed  Google Scholar 

  4. Castillo MJ, Scheen AJ, Jandrain B, Lefèbvre PJ . Relationships between metabolic clearance rate of insulin and body mass index in a female population ranging from anorexia nervosa to severe obesity. Int J Obes Relat Metab Disord 1994; 18: 47–53.

    CAS  PubMed  Google Scholar 

  5. Pereira JA, Claro BM, Pareja JC, Chaim EA, Astiarraga BD, Saad MJA, Muscelli E . Restored insulin inhibition on insulin secretion in nondiabetic severely obese patients after weight loss induced by bariatric surgery. Int J Obes Relat Metab Disord 2003; 27: 463–468.

    Article  CAS  PubMed  Google Scholar 

  6. Muscelli E, Pereira JA, Lazarin MACT, Silva CA, Pareja JC, Saad MJA . Lack of insulin inhibition on insulin secretion in nondiabetic morbidly obese patients. Int J Obes Relat Metab Disord 2001; 25: 798–804.

    Article  CAS  PubMed  Google Scholar 

  7. Scheen A, Castillo M, Paolisso G, Jandrain B, Lefèbvre PJ . Normal feedback inhibition of insulin secretion by insulin but reduced metabolic clearance rate of the hormone in obese subjects. In: Ailhaud G, Guy-Grand B, Lafontaine M, Ricquier D (eds). Obesity in Europe 91. John Libbey & Co.: London; 1992. pp 201–205.

    Google Scholar 

  8. Jimenez J, Zuniga-Guajardo S, Zinman B, Angel A . Effects of weight loss in massive obesity on insulin and C-peptide dynamics: sequential changes in insulin production, clearance, and sensitivity. J Clin Endocrinol Metab 1987; 64: 661–668.

    Article  CAS  PubMed  Google Scholar 

  9. Letiexhe MR, Scheen AJ, Gérard PL, Desaive C, Lefèbvre PJ . Insulin secretion, clearance and action before and after gastroplasty in severely obese subjects. Int J Obes Relat Metab Disord 1994; 18: 295–300.

    CAS  PubMed  Google Scholar 

  10. Letiexhe MR, Scheen AJ, Gérard PL, Desaive C, Lefèbvre PJ . Post-gastroplasty recovery of ideal body weight normalizes glucose and insulin metabolism in obese women. J Clin Endocrinol Metab 1995; 80: 364–369.

    CAS  PubMed  Google Scholar 

  11. Kahn SE, Prigeon RL, McCulloch DK, Boyko EJ, Bergman RN, Schwartz MW, Neifin JL, Ward WK, Beard JC, Palmer JP, Porte D . Quantification of the relationship between insulin sensitivity and β-cell function in human subjects. Diabetes 1993; 42: 1663–1672.

    Article  CAS  PubMed  Google Scholar 

  12. Bergman RN, Ader M, Huecking K, Van Citters G . Accurate assessment of β-cell function. Diabetes 2002; 51 (Suppl 1): S212–S220.

    Article  CAS  PubMed  Google Scholar 

  13. Stumvoll M, Tataranni A, Stefan N, Vozarova B, Bogardus C . Persectives in diabetes. Glucose Allostasis. Diabetes 2003; 52: 903–909.

    Article  CAS  PubMed  Google Scholar 

  14. Letiexhe MR, Scheen AJ, Desaive C, Lefèbvre PJ . Hyperbolic relationship between changes in insulin secretion and action in obese subjects after gastroplasty (Abstract). Diabetologia 1995; 38 (Suppl 1): A158.

    Google Scholar 

  15. Sjöström CD, Peltonen M, Wedel H, Sjöström L . Differentiated long-term effects of intentional weight loss on diabetes and hypertension. Hypertension 2000; 36: 20–25.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Diabetes, Department of Medicine, Nutrition and Metabolic Disorders, CHU Sart Tilman, Liège, Belgium

    M R Letiexhe, P J Lefèbvre & A J Scheen

  2. Department of surgery, CHU Sart Tilman, Liège, Belgium

    C Desaive

Authors
  1. M R Letiexhe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C Desaive
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P J Lefèbvre
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A J Scheen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A J Scheen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Letiexhe, M., Desaive, C., Lefèbvre, P. et al. Intact cross-talk between insulin secretion and insulin action after postgastroplasty recovery of ideal body weight in severely obese patients. Int J Obes 28, 821–823 (2004). https://doi.org/10.1038/sj.ijo.0802632

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802632

Keywords

This article is cited by

Search

Advanced search

Quick links