{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:04:44Z","timestamp":1781715884995,"version":"3.54.5"},"reference-count":28,"publisher":"American Diabetes Association","issue":"2","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Washington University School of Medicine Diabetes Research Center","award":["P30 DK020579"],"award-info":[{"award-number":["P30 DK020579"]}]},{"name":"Washington University School of Medicine Institute of Clinical and Translational Sciences","award":["UL1 TR000448"],"award-info":[{"award-number":["UL1 TR000448"]}]},{"DOI":"10.13039\/100003085","name":"Longer Life Foundation","doi-asserted-by":"publisher","award":["2019-11"],"award-info":[{"award-number":["2019-11"]}],"id":[{"id":"10.13039\/100003085","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Washington University School of Medicine Nutrition Obesity Research Center","award":["P30 DK056341"],"award-info":[{"award-number":["P30 DK056341"]}]},{"name":"NIH","award":["R01 DK101578"],"award-info":[{"award-number":["R01 DK101578"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>We used a dual (intravenous and oral) glucose tracer protocol to evaluate rates of glucose appearance in the circulation, insulin-mediated glucose disposal (IMGD), and noninsulin-mediated glucose disposal (NIMGD) for 4 h after consumption of a mixed meal in people with obesity and type 2 diabetes before and after marked (\u223c20%) weight loss, induced by behavioral diet therapy (BDT, n = 11) or Roux-en-Y gastric bypass (RYGB) surgery (n = 9). Total postprandial glucose appearance rate was lower after compared with before weight loss in both the BDT and RYGB groups because of a decrease in endogenous glucose production, without a difference between groups. However, the decreases in total and incremental postprandial plasma glucose concentration areas under the curve were greater in the BDT group than the RYGB group because IMGD doubled in the BDT group but did not change in the RYGB group. These results demonstrate that the improvement in postprandial glycemia is greater after marked, matched weight loss induced by BDT compared with RYGB in people with obesity and type 2 diabetes, because of increased IMGD after BDT but not RYGB. Nonetheless, these findings do not diminish the potent therapeutic effect of RYGB surgery on glycemic control and even achieving remission of type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Article Highlights<\/jats:title>\n                    <jats:p>In people with obesity and diabetes, marked (\u223c20%) weight loss induced by behavioral diet therapy (BDT) causes a greater decrease in postprandial plasma glucose area under the curve than matched weight loss after Roux-en-Y gastric bypass (RYGB), even though insulin sensitivity and postprandial plasma insulin area under the curve are the same in both groups. We studied the effects of marked weight loss after BDT or RYGB on insulin-mediated glucose disposal (IMGD) and non\u2013insulin-mediated glucose disposal. Weight loss induced by BDT, but not RYGB, increased IMGD. Postprandial glycemia improves more after marked weight loss induced by BDT than by RYGB because of increased IMGD after BDT but not RYGB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/db25-0737","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T17:13:09Z","timestamp":1764177189000},"page":"264-272","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Marked Weight Loss Induced by Gastric Bypass Surgery or Low-Calorie Diet Alone on Postprandial Glucose Disposal in Type 2 Diabetes"],"prefix":"10.2337","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0049-2677","authenticated-orcid":false,"given":"Bettina","family":"Mittendorfer","sequence":"first","affiliation":[{"name":"Center for Human Nutrition, Washington University School of Medicine 1 , St. Louis, MO"},{"name":"Departments of Medicine and Nutrition & Exercise Physiology, University of Missouri School of Medicine 2 , Columbia, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce W.","family":"Patterson","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition, Washington University School of Medicine 1 , St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Christopher","family":"Eagon","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition, Washington University School of Medicine 1 , St. Louis, MO"},{"name":"Department of Surgery, Washington University School of Medicine, St. Louis 3 , MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihoko","family":"Yoshino","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition, Washington University School of Medicine 1 , St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7127-1156","authenticated-orcid":false,"given":"Samuel","family":"Klein","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition, Washington University School of Medicine 1 , St. Louis, MO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"2026061712172224400_B1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1152\/physrev.00015.2022","article-title":"Evolution of the diagnostic value of \u201cthe sugar of the blood\u201d: hitting the sweet spot to identify alterations in glucose dynamics","volume":"103","author":"Magkos","year":"2023","journal-title":"Physiol Rev"},{"key":"2026061712172224400_B2","doi-asserted-by":"crossref","first-page":"773","DOI":"10.2337\/db09-9028","article-title":"Banting Lecture. 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