Skip to Main content Skip to Navigation
Journal articles

Differences in Alimentary Glucose 1 Absorption and Intestinal Disposal of Blood Glucose Following Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy: Intestinal glucose handling after bariatric surgery

Abstract : Background & Aims: Bariatric surgeries, such as Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), are the most effective approaches to resolve type 2 diabetes in obese individuals. Alimentary glucose absorption and intestinal disposal of blood glucose have not been directly compared between individuals or animals that underwent RYGB vs VSG. We evaluated in rats and humans how the gut epithelium adapts following surgery and the consequences on alimentary glucose absorption and intestinal disposal of blood glucose. Methods: Obese male rats underwent RYGB, VSG, or sham (control) surgeries. We collected intestine segments from all rats; we performed histologic analyses and measured levels of mRNAs encoding the sugar transporters SGLT1, GLUT1, GLUT2, GLUT3, GLUT4 and GLUT5. Glucose transport and consumption were assayed using ex vivo jejunal loops. Histologic analyses were also performed on Roux limb sections from patients who underwent RYGB, 1–5 years after surgery. Roux limb glucose consumption was assayed following surgery by positron emission and computed tomography imaging. Results: In rats and humans that underwent RYGB, the Roux limb became hyperplasic, with an increased number of incretin-producing cells, compared with the corresponding jejunal segment of controls. Furthermore, expression of sugar transporters and hypoxia-related genes increased and the non-intestinal glucose transporter GLUT1 appeared at the basolateral membrane of enterocytes. Ingested and circulating glucose was trapped within the intestinal epithelial cells of rats and humans that underwent RYGB. By contrast, there was no hyperplasia of the intestine after VSG, but the intestinal absorption of alimentary glucose was reduced and density of endocrine cells secreting glucagon-like peptide-1 (GLP1) increased. Conclusions: The intestine adapts differently to RYGB vs VSG. RYGB increases intestinal glucose disposal, whereas VSG delays glucose absorption; both contribute to observed improvements in glycemia.
Document type :
Journal articles
Complete list of metadatas

Cited literature [3 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-01346236
Contributor : Maude Le Gall <>
Submitted on : Monday, July 18, 2016 - 3:17:39 PM
Last modification on : Wednesday, August 19, 2020 - 11:18:10 AM

File

GASTRO-D-15-01330 Version com...
Files produced by the author(s)

Identifiers

Collections

Citation

Jean-Baptiste Cavin, Anne Couvelard, Rachida Lebtahi, Robert Ducroc, Konstantinos Arapis, et al.. Differences in Alimentary Glucose 1 Absorption and Intestinal Disposal of Blood Glucose Following Roux-en-Y Gastric Bypass vs Sleeve Gastrectomy: Intestinal glucose handling after bariatric surgery . Gastroenterology, WB Saunders, 2015, 150 (2), pp.454-64. ⟨10.1053/j.gastro.2015.10.009.⟩. ⟨inserm-01346236⟩

Share

Metrics

Record views

780

Files downloads

812