Navigation Links
Cause for exaggerated insulin response in subset of bariatric surgery patients identified

CINCINNATIUniversity of Cincinnati (UC) researchers have discovered that altered islet cell function and reduced insulin clearance contribute to excessive post-meal insulin response in patients experiencing low blood sugar symptoms (hypoglycemia) following gastric bypass surgery.

These findings, led by Marzieh Salehi, MD, associate professor in the UC division of endocrinology, metabolism and diabetes, are featured online this month in The Journal of Clinical Endocrinology & Metabolism, and are part of an ongoing effort by UC researchers to better understand the effect of gastric bypass surgery on glucose metabolism and islet function.

Gastric bypass surgery has been shown to be one of the most effective treatments for obesity, and often improves Type 2 diabetes immediately after surgery and long before any weight loss has occurreda phenomenon that's been attributed to earlier and larger insulin response to meal ingestion.

"For the majority of patients with diabetes, gastric bypass surgery leads to improved glucose control, but a subset of patients develop post-meal hypoglycemiaassociated with too much of an insulin responseseveral years after surgery," says Salehi, also a physician with UC Health.

For this study Salehi and colleagues enrolled 65 subjects who had gastric bypass surgery at least two years prior to enrollment. Participants were stratified based on post-meal symptoms of low blood sugar and studied during meal tolerance tests.

"We have shown that meal ingestion after gastric bypass surgery causes an earlier and larger peak of insulin secretion, and this effect is exaggerated in those with hypoglycemic symptoms following meals," says Salehi, who adds that the effect is particularly exaggerated in those with neuroglycopenic symptoms (cognitive abnormalities, loss of consciousness, and seizure) rather than autonomic symptoms (fast heart beats, sweating, tingling, fatigue).

According to Salehi and team, this is the largest group of gastric bypass patients with post-meal symptoms of low blood sugar to be reported to date; and among this group, abnormalities in insulin clearance as well as excessive insulin secretion during glucose drops (hyperinsulinemia) were identified.

"These abnormalities contributed to elevated insulin response and lower glucose levels in these individuals," says Salehi.

Moreover, Salehi says, findings from this study suggest that in addition to excessive insulin secretion, glucagon response to hypoglycemia is abnormal. Glucagon is another important hormone in glucose regulation. It is secreted from specific cells in the pancreas in response to low glucose.

This study, the authors says, offers a better understanding of mechanisms by which gastric bypass surgery alters glucose metabolism in general, and more specifically in those individuals suffering from hyperinsulinemic hypoglycemia syndrome.

At this point, Salehi adds, there is no specific therapeutic option available for patients with this condition beyond dietary modification; however, we expect that the future studies based on current findings will inform the development of medical and dietary interventions for treatment of this condition.


Contact: Angela Koenig
University of Cincinnati Academic Health Center

Related biology news :

1. The causes and consequences of global climate warming that took place 56 million years ago studied
2. Leukaemia caused by chromosome catastrophe
3. TGen-led study discovers genetic cause of rare type of ovarian cancer
4. Among US children, more infections caused by drug-resistant bacteria
5. TGen study identifies gene fusion as likely cause of rare type of thyroid cancer
6. Gut bacteria can cause life-threatening infections in preterm babies
7. Bacterium and fungus team up to cause virulent tooth decay in toddlers
8. A new cell type is implicated in epilepsy caused by traumatic brain injury
9. Virtual bees help to unravel complex causes of colony decline
10. Famed Milwaukee County Zoo orangutans death caused by strange infection
11. Climate change causes high, but predictable, extinction risks
Post Your Comments:
(Date:11/2/2015)... Calif. , Nov. 2, 2015  SRI International ... million to provide preclinical development services to the National ... contract, SRI will provide scientific expertise, modern testing and ... variety of preclinical pharmacology and toxicology studies to evaluate ... --> The PREVENT Cancer Drug Development Program ...
(Date:10/29/2015)... ARBOR, Mich. , Oct. 29, 2015 /PRNewswire/ ... Eurofins Genomics for U.S. distribution of its DNA ... DNA-seq kit and Rubicon,s new ThruPLEX Plasma-seq kit. ... to enable the preparation of NGS libraries for ... plasma for diagnostic and prognostic applications in cancer ...
(Date:10/27/2015)... 27, 2015 In the present market scenario, ... for various industry verticals such as banking, healthcare, defense, ... growing demand for secure & simplified access control and ... as hacking of bank accounts, misuse of users, , ... as PC,s, laptops, and smartphones are expected to provide ...
Breaking Biology News(10 mins):
(Date:11/25/2015)... , Nov. 25, 2015 Orexigen® Therapeutics, ... will participate in a fireside chat discussion at the ... New York . The discussion is scheduled for ... .  A replay will be available ... Contact:McDavid Stilwell  , Julie NormartVP, Corporate Communications and ...
(Date:11/24/2015)... 24, 2015  Asia-Pacific (APAC) holds the third-largest ... market. The trend of outsourcing to low-cost locations ... higher volume share for the region in the ... margins in the CRO industry will improve. ... ( ), finds that the market earned ...
(Date:11/24/2015)... DIEGO , Nov. 24, 2015 Halozyme Therapeutics, Inc. ... Healthcare Conference in New York on Wednesday, ... Helen Torley , president and CEO, will provide a corporate ... New York at 1:00 p.m. ET/10:00 a.m. PT ... and investor relations, will provide a corporate overview. --> ...
(Date:11/24/2015)... Florida (PRWEB) , ... November 24, 2015 , ... ... biggest event of the year and one of the premier annual events for ... and ran from 8–11 November 2015, where ISPE hosted the largest number of ...
Breaking Biology Technology: