{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:54:16Z","timestamp":1791186856535,"version":"4.1.0"},"reference-count":20,"publisher":"The Endocrine Society","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context:<\/jats:title>\n                  <jats:p>Gastric bypass surgery (GBP) results in the rapid resolution of type 2 diabetes. Most studies aiming to explain the underlying mechanisms are limited to data obtained after a postsurgical recovery period, making assessment of confounding influences from, for example, weight loss and altered nutrient intake difficult.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To examine the impact of GBP on hormonal and metabolite profiles under conditions of identical nutrient intake independent of weight loss, we studied GBP patients fitted with a gastrostomy tube to enable the administration of nutrients to bypassed segments of the gut. Thus, this model allowed us to simulate partially the preoperative condition and compare this with the postoperative situation in the same patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Patients (n = 4) were first given a mixed meal test (MMT) orally and then via the gastrostomy tube, preceded by overnight and 2-hour fasting, respectively. Blood samples were assessed for hormones and metabolites.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>The oral MMT yielded 4.6-fold increase in plasma insulin (P &amp;lt; .05), 2-fold in glucagon-like peptide-1 (P &amp;lt; .05), and 2.5-fold in glucose-dependent insulinotropic peptide (P &amp;lt; .05) plasma levels, compared with the gastrostomy MMT. The changes in hormone levels were accompanied by elevated branched-chain amino acid levels (1.4\u20132-fold, P &amp;lt; .05) and suppressed fatty acid levels (\u223c50%, P &amp;lt; .05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>These data, comparing identical nutrient delivery, demonstrate markedly higher incretin and insulin responses after oral MMT than after gastric MMT, thereby providing a potential explanation for the rapid remission of type 2 diabetes observed after GBP. The simultaneous increase in branched-chain amino acid questions its role as a marker for insulin resistance.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2012-3996","type":"journal-article","created":{"date-parts":[[2013,5,1]],"date-time":"2013-05-01T15:29:44Z","timestamp":1367422184000},"page":"E856-E861","source":"Crossref","is-referenced-by-count":36,"title":["Effects of Ingestion Routes on Hormonal and Metabolic Profiles in Gastric-Bypassed Humans"],"prefix":"10.1210","volume":"98","author":[{"given":"Andreas","family":"Lindqvist","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences (A.L., P.S., H.M., L.G., N.W.), Lund University Diabetes Centre, Lund University, SE-205 02 Malm\u00f6, Sweden;"},{"name":"Aleris Obesitas (A.L., J.H.), SE-222 70 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Sp\u00e9gel","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences (A.L., P.S., H.M., L.G., N.W.), Lund University Diabetes Centre, Lund University, SE-205 02 Malm\u00f6, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Ekelund","sequence":"additional","affiliation":[{"name":"Department of Surgery (M.E., J.H.), Lund University, SE-22 184 Lund, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hindrik","family":"Mulder","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences (A.L., P.S., H.M., L.G., N.W.), Lund University Diabetes Centre, Lund University, SE-205 02 Malm\u00f6, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leif","family":"Groop","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences (A.L., P.S., H.M., L.G., N.W.), Lund University Diabetes Centre, Lund University, SE-205 02 Malm\u00f6, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Hedenbro","sequence":"additional","affiliation":[{"name":"Department of Surgery (M.E., J.H.), Lund University, SE-22 184 Lund, Sweden;"},{"name":"Aleris Obesitas (A.L., J.H.), SE-222 70 Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Wierup","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences (A.L., P.S., H.M., L.G., N.W.), Lund University Diabetes Centre, Lund University, SE-205 02 Malm\u00f6, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","reference":[{"key":"2020071613480373600_B1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.amjmed.2008.09.041","article-title":"Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis","volume":"122","author":"Buchwald","year":"2009","journal-title":"Am J Med"},{"key":"2020071613480373600_B2","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1381\/096089206779319338","article-title":"GLP-1 and changes in glucose tolerance following gastric bypass surgery in morbidly obese subjects","volume":"16","author":"Morinigo","year":"2006","journal-title":"Obes Surg"},{"key":"2020071613480373600_B3","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1056\/NEJMoa1112082","article-title":"Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects","volume":"367","author":"Carlsson","year":"2012","journal-title":"N Engl J Med"},{"key":"2020071613480373600_B4","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/S0016-5085(83)80080-8","article-title":"Endocrine cells in human intestine: an immunocytochemical study","volume":"85","author":"Sj\u00f6lund","year":"1983","journal-title":"Gastroenterology"},{"key":"2020071613480373600_B5","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1007\/s00125-012-2556-7","article-title":"Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass","volume":"55","author":"Dirksen","year":"2012","journal-title":"Diabetologia"},{"key":"2020071613480373600_B6","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.surg.2007.03.001","article-title":"How the hindgut can cure type 2 diabetes. 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