{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T20:16:19Z","timestamp":1779912979568,"version":"3.53.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2016,1,20]],"date-time":"2016-01-20T00:00:00Z","timestamp":1453248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sleeve gastrectomy is indicated for the treatment of obesity and related co-morbidity including diabetes. The dynamic changes in insulin secretion and sensitivity after sleeve gastrectomy are unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Whole-body insulin sensitivity was measured by the euglycaemic hyperinsulinaemic clamp technique, and insulin secretion by C-peptide deconvolution after an oral glucose tolerance test (OGTT), before and 3, 6 and 12 months after sleeve gastrectomy in morbidly obese subjects. The time course of glucagon-like peptide (GLP) 1, as a marker of insulin secretion following OGTT, was also assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ten patients were included in the study. Median (range) baseline insulin sensitivity (M-value) increased from 84\u00b70 (20\u00b72\u2013131\u00b74) mmol per kg per min at baseline to 122\u00b78 (99\u00b70\u2013179\u00b73) mmol per kg per min at 12 months after surgery (P = 0\u00b7015). Fasting insulin sensitivity, measured by homeostatic model assessment of insulin resistance, which represents a surrogate index of hepatic insulin resistance, decreased from 3\u00b73 (1\u00b79\u20135\u00b75) to 0\u00b77 (0\u00b75\u20131\u00b71) mg\/dl\u00b7\u00b5units\/ml (P &amp;lt; 0\u00b7001). Total insulin secretion, measured as incremental area under the curve (AUC), after OGTT decreased from 360\u00b74 (347\u00b79\u2013548\u00b70) to 190\u00b71 (10\u00b71\u2013252\u00b70) mmol\/l\u00b7180 min at 12 months (P = 0\u00b7011). The AUC for GLP-1 increased from 258\u00b75 (97\u00b75\u2013552\u00b76) to 5531\u00b78 (4143\u00b70\u20137540\u00b79) pmol\/l\u00b7180 min at 12 months after sleeve gastrectomy (P &amp;lt; 0\u00b7001). In multiple regression analysis, 51 per cent of the M-value variability was explained by GLP-1 secretion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Sleeve gastrectomy improved insulin sensitivity and reduced insulin secretion within 6 months after surgery. Although there was a correlation between insulin sensitivity and bodyweight, the major driver of the improvement in insulin sensitivity was GLP-1 secretion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10039","type":"journal-article","created":{"date-parts":[[2015,11,9]],"date-time":"2015-11-09T13:38:45Z","timestamp":1447076325000},"page":"242-248","source":"Crossref","is-referenced-by-count":35,"title":["Changes in insulin sensitivity and secretion after sleeve gastrectomy"],"prefix":"10.1093","volume":"103","author":[{"given":"G","family":"Casella","sequence":"first","affiliation":[{"name":"Surgical Sciences Department, Medical School \u2018Sapienza\u2019 University , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Soricelli","sequence":"additional","affiliation":[{"name":"Surgical Sciences Department, Medical School \u2018Sapienza\u2019 University , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Castagneto-Gissey","sequence":"additional","affiliation":[{"name":"Surgical Sciences Department, Medical School \u2018Sapienza\u2019 University , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Redler","sequence":"additional","affiliation":[{"name":"Surgical Sciences Department, Medical School \u2018Sapienza\u2019 University , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Basso","sequence":"additional","affiliation":[{"name":"Surgical Sciences Department, Medical School \u2018Sapienza\u2019 University , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Mingrone","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Catholic University of Rome , Rome,","place":["Italy"]},{"name":"Department of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King's College , London,","place":["UK"]},{"name":"Medizinische Klinik und Poliklinik III, Universit\u00e4tsklinikum Carl Gustav Carus an der Technischen Universit\u00e4t , Dresden,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,2,1]]},"reference":[{"key":"2024092914150424300_bjs10039-bib-0001","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1056\/NEJMoa1401329","article-title":"Bariatric surgery versus intensive medical therapy for diabetes \u2013 3-year outcomes","volume":"370","author":"Schauer","year":"2014","journal-title":"N Engl J Med"},{"key":"2024092914150424300_bjs10039-bib-0002","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1007\/s00464-009-0715-9","article-title":"Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes","volume":"24","author":"Abbatini","year":"2010","journal-title":"Surg Endosc"},{"key":"2024092914150424300_bjs10039-bib-0003","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.soard.2012.09.003","article-title":"Long-term remission of type 2 diabetes in morbidly obese patients after sleeve gastrectomy","volume":"9","author":"Abbatini","year":"2013","journal-title":"Surg Obes Relat Dis"},{"key":"2024092914150424300_bjs10039-bib-0004","doi-asserted-by":"crossref","first-page":"2479","DOI":"10.1210\/jc.2007-2851","article-title":"Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes","volume":"93","author":"Laferr\u00e8re","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"2024092914150424300_bjs10039-bib-0005","doi-asserted-by":"crossref","first-page":"42","DOI":"10.2337\/dc11-1472","article-title":"Magnitude and variability of the glucagon-like peptide-1 response in patients with type 2 diabetes up to 2 years following gastric bypass surgery","volume":"35","author":"Van der Schueren","year":"2012","journal-title":"Diabetes Care"},{"key":"2024092914150424300_bjs10039-bib-0006","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/SLA.0b013e318269cf5c","article-title":"Insulin sensitivity and secretion changes after gastric bypass in normotolerant and diabetic obese subjects","volume":"257","author":"Salinari","year":"2013","journal-title":"Ann Surg"},{"key":"2024092914150424300_bjs10039-bib-0007","doi-asserted-by":"crossref","first-page":"2025","DOI":"10.2337\/db06-0068","article-title":"Mechanisms of recovery from type 2 diabetes after malabsorptive bariatric surgery","volume":"55","author":"Guidone","year":"2006","journal-title":"Diabetes"},{"key":"2024092914150424300_bjs10039-bib-0008","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2337\/dc08-1314","article-title":"First-phase insulin secretion restoration and differential response to glucose load depending on the route of administration in type 2 diabetic subjects after bariatric surgery","volume":"32","author":"Salinari","year":"2009","journal-title":"Diabetes Care"},{"key":"2024092914150424300_bjs10039-bib-0009","doi-asserted-by":"crossref","first-page":"E122","DOI":"10.1152\/ajpendo.00073.2012","article-title":"Acute and long-term effects of Roux-en-Y gastric bypass on glucose metabolism in subjects with type 2 diabetes and normal glucose tolerance","volume":"303","author":"J\u00f8rgensen","year":"2012","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2024092914150424300_bjs10039-bib-0010","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1056\/NEJMoa1200225","article-title":"Bariatric surgery versus intensive medical therapy in obese patients with diabetes","volume":"366","author":"Schauer","year":"2012","journal-title":"N Engl J Med"},{"key":"2024092914150424300_bjs10039-bib-0011","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/01.mco.0000232914.14978.c5","article-title":"Bariatric surgery: effects on glucose homeostasis","volume":"9","author":"Rubino","year":"2006","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"2024092914150424300_bjs10039-bib-0012","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1002\/oby.20803","article-title":"Matched weight loss induced by sleeve gastrectomy or gastric bypass similarly improves metabolic function in obese subjects","volume":"22","author":"Bradley","year":"2014","journal-title":"Obesity (Silver Spring)"},{"key":"2024092914150424300_bjs10039-bib-0013","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.2337\/dc12-1596","article-title":"Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment","volume":"36","author":"Kashyap","year":"2013","journal-title":"Diabetes Care"},{"key":"2024092914150424300_bjs10039-bib-0014","doi-asserted-by":"crossref","first-page":"3540","DOI":"10.1007\/s00464-011-1755-5","article-title":"First-phase insulin secretion, insulin sensitivity, ghrelin, GLP-1, and PYY changes 72 h after sleeve gastrectomy in obese diabetic patients: the gastric hypothesis","volume":"25","author":"Basso","year":"2011","journal-title":"Surg Endosc"},{"key":"2024092914150424300_bjs10039-bib-0015","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s00595-007-3645-y","article-title":"Laparoscopic sleeve gastrectomy for the super-super-obese (body mass index &gt; 60 kg\/m2)","volume":"38","author":"Gagner","year":"2008","journal-title":"Surg Today"},{"key":"2024092914150424300_bjs10039-bib-0016","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: insulin resistance and \u03b2-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"2024092914150424300_bjs10039-bib-0017","first-page":"E214","article-title":"Glucose clamp technique: a method for quantifying insulin secretion and resistance","volume":"237","author":"DeFronzo","year":"1979","journal-title":"Am J Physiol"},{"key":"2024092914150424300_bjs10039-bib-0018","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1172\/JCI113338","article-title":"Quantitative study of insulin secretion and clearance in normal and obese subjects","volume":"81","author":"Polonsky","year":"1988","journal-title":"J Clin Invest"},{"key":"2024092914150424300_bjs10039-bib-0019","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.soard.2011.03.010","article-title":"Bypass of the duodenum improves insulin resistance much more rapidly than sleeve gastrectomy","volume":"8","author":"Garrido-Sanchez","year":"2012","journal-title":"Surg Obes Relat Dis"},{"key":"2024092914150424300_bjs10039-bib-0020","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1053\/j.gastro.2011.05.050","article-title":"Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats","volume":"141","author":"Chambers","year":"2011","journal-title":"Gastroenterology"},{"key":"2024092914150424300_bjs10039-bib-0021","doi-asserted-by":"crossref","first-page":"3372","DOI":"10.2337\/db14-0357","article-title":"GLP-1 and glucose tolerance after sleeve gastrectomy in morbidly obese subjects with type 2 diabetes","volume":"63","author":"Jim\u00e9nez","year":"2014","journal-title":"Diabetes"},{"key":"2024092914150424300_bjs10039-bib-0022","doi-asserted-by":"crossref","first-page":"E318","DOI":"10.1152\/ajpendo.00191.2010","article-title":"GLP-1 treatment reduces endogenous insulin resistance via activation of central GLP-1 receptors in mice fed a high-fat diet","volume":"299","author":"Parlevliet","year":"2010","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2024092914150424300_bjs10039-bib-0023","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.2337\/diabetes.48.5.1026","article-title":"Glucose-lowering and insulin-sensitizing actions of exendin-4: studies in obese diabetic (ob\/ob, db\/db) mice, diabetic fatty Zucker rats, and diabetic rhesus monkeys (Macaca mulatta)","volume":"48","author":"Young","year":"1999","journal-title":"Diabetes"},{"key":"2024092914150424300_bjs10039-bib-0024","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/S0140-6736(02)07952-7","article-title":"Effect of 6-week course of glucagon-like peptide 1 on glycaemic control, insulin sensitivity, and beta-cell function in type 2 diabetes: a parallel-group study","volume":"359","author":"Zander","year":"2002","journal-title":"Lancet"},{"key":"2024092914150424300_bjs10039-bib-0025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0044284","article-title":"Glucagon like peptide-1-induced glucose metabolism in differentiated human muscle satellite cells is attenuated by hyperglycemia","volume":"7","author":"Green","year":"2012","journal-title":"PLoS One"},{"key":"2024092914150424300_bjs10039-bib-0026","doi-asserted-by":"crossref","first-page":"E424","DOI":"10.1152\/ajpendo.00469.2013","article-title":"Regulation of gastric emptying rate and its role in nutrient-induced GLP-1 secretion in rats after vertical sleeve gastrectomy","volume":"306","author":"Chambers","year":"2014","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2024092914150424300_bjs10039-bib-0027","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1097\/SLA.0b013e3182774522","article-title":"Alterations of global gastrointestinal motility after sleeve gastrectomy: a prospective study","volume":"258","author":"Melissas","year":"2013","journal-title":"Ann Surg"},{"key":"2024092914150424300_bjs10039-bib-0028","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s11695-014-1410-z","article-title":"Association between postprandial symptoms and gastric emptying after sleeve gastrectomy","volume":"25","author":"Burgerhart","year":"2014","journal-title":"Obes Surg"},{"key":"2024092914150424300_bjs10039-bib-0029","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1007\/s11695-012-0711-3","article-title":"Dumping symptoms and incidence of hypoglycaemia after provocation test at 6 and 12 months after laparoscopic sleeve gastrectomy","volume":"22","author":"Papamargaritis","year":"2012","journal-title":"Obes Surg"},{"key":"2024092914150424300_bjs10039-bib-0030","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.2337\/diacare.28.5.1245","article-title":"Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia","volume":"28","author":"Workgroup on Hypoglycemia, American Diabetes Association","year":"2005","journal-title":"Diabetes Care"},{"key":"2024092914150424300_bjs10039-bib-0031","doi-asserted-by":"crossref","first-page":"E67","DOI":"10.1152\/ajpendo.1991.260.1.E67","article-title":"Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction","volume":"260","author":"Mitrakou","year":"1991","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2024092914150424300_bjs10039-bib-0032","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1056\/NEJMra031354","article-title":"Diverse causes of hypoglycemia-associated autonomic failure in diabetes","volume":"350","author":"Cryer","year":"2004","journal-title":"N Engl J Med"},{"key":"2024092914150424300_bjs10039-bib-0033","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.soard.2014.11.003","article-title":"Hypoglycemia after Roux-en-Y gastric bypass: detection rates of continuous glucose monitoring (CGM) versus mixed meal test","volume":"11","author":"Kefurt","year":"2015","journal-title":"Surg Obes Relat Dis"},{"key":"2024092914150424300_bjs10039-bib-0034","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1007\/s00464-010-1489-9","article-title":"Abnormal glucose tolerance testing following gastric bypass demonstrates reactive hypoglycemia","volume":"25","author":"Roslin","year":"2011","journal-title":"Surg Endosc"},{"key":"2024092914150424300_bjs10039-bib-0035","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1210\/jcem.87.3.8355","article-title":"Effects of glucagon-like peptide 1 on counterregulatory hormone responses, cognitive functions, and insulin secretion during hyperinsulinemic, stepped hypoglycemic clamp experiments in healthy volunteers","volume":"87","author":"Nauck","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2024092914150424300_bjs10039-bib-0036","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1136\/gut.33.4.466","article-title":"Relation of pyloric motility to pyloric opening and closure in healthy subjects","volume":"33","author":"Tougas","year":"1992","journal-title":"Gut"},{"key":"2024092914150424300_bjs10039-bib-0037","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1007\/s11695-008-9576-x","article-title":"Laparoscopic sleeve gastrectomy \u2013 volume and pressure assessment","volume":"18","author":"Yehoshua","year":"2008","journal-title":"Obes Surg"},{"key":"2024092914150424300_bjs10039-bib-0038","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.cmet.2015.01.001","article-title":"The role of gut adaptation in the potent effects of multiple bariatric surgeries on obesity and diabetes","volume":"21","author":"Seeley","year":"2015","journal-title":"Cell Metab"},{"key":"2024092914150424300_bjs10039-bib-0039","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/nrendo.2013.100-c1","article-title":"Sleeve gastrectomy: the ideal option for metabolic surgery?","volume":"9","author":"Cohen","year":"2013","journal-title":"Nat Rev Endocrinol"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.10039","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/103\/3\/242\/59432981\/bjs10039.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/103\/3\/242\/59432981\/bjs10039.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T14:15:17Z","timestamp":1727619317000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/103\/3\/242\/6136581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,20]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2016,2,1]]},"published-print":{"date-parts":[[2016,1,20]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.10039","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2016,2]]},"published":{"date-parts":[[2016,1,20]]}}}