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Effect of bariatric surgery combined with medical therapy versus intensive medical therapy or caloric restriction and weight loss on glycemic control in ZDF rat


Abegg, Kathrin; Corteville, Caroline; Docherty, Neil G; Boza, Camilo; Lutz, Thomas A; Munoz, Rodrigo; le Roux, Carel W (2015). Effect of bariatric surgery combined with medical therapy versus intensive medical therapy or caloric restriction and weight loss on glycemic control in ZDF rat. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 308(4):R321-9.

Abstract

Background: Bariatric surgery rapidly improves type 2 diabetes mellitus (T2DM). Our objective was to profile and compare the extent and duration of improved glycemic control following Roux-en-Y gastric (RYGB) bypass surgery and vertical sleeve gastrectomy (SG) and compare against caloric restriction/weight loss and medical combination therapy based approaches using the Zucker diabetic fatty rat (ZDF) rodent model of advanced T2DM. Methods: Male ZDF rats underwent RYGB (n=15) or SG surgery (n=10) at 18 weeks of age and received postsurgical insulin treatment as required to maintain mid light phase glycemia within a predefined range (10-15 mmol/L). In parallel, further groups of animals underwent sham surgery with ad libitum feeding (n=6), with bodyweight (n=8) or glycemic matching (n=8) to the RYGB group using food restriction or a combination of insulin, metformin and liraglutide respectively. Results: Both bariatric procedures decreased the daily insulin dose required to maintain mid light phase blood glucose levels below 15 mmol/L as compared to those required by bodyweight or glycemic matched rats (p < 0.001). No difference was noted between RYGB and SG with regard to initial efficacy. SG was however associated with higher food intake, weight regain and higher insulin requirements versus RYGB at study end (p < 0.05). Severe hypoglycemia occurred in several rats after RYGB. Conclusions: RYGB and SG significantly improved glycemic control in a rodent model of advanced T2DM. Whilst short-term outcomes are similar, long-term efficacy appears marginally better after RYGB although this is tempered by the increased risk of hypoglycemia.

Abstract

Background: Bariatric surgery rapidly improves type 2 diabetes mellitus (T2DM). Our objective was to profile and compare the extent and duration of improved glycemic control following Roux-en-Y gastric (RYGB) bypass surgery and vertical sleeve gastrectomy (SG) and compare against caloric restriction/weight loss and medical combination therapy based approaches using the Zucker diabetic fatty rat (ZDF) rodent model of advanced T2DM. Methods: Male ZDF rats underwent RYGB (n=15) or SG surgery (n=10) at 18 weeks of age and received postsurgical insulin treatment as required to maintain mid light phase glycemia within a predefined range (10-15 mmol/L). In parallel, further groups of animals underwent sham surgery with ad libitum feeding (n=6), with bodyweight (n=8) or glycemic matching (n=8) to the RYGB group using food restriction or a combination of insulin, metformin and liraglutide respectively. Results: Both bariatric procedures decreased the daily insulin dose required to maintain mid light phase blood glucose levels below 15 mmol/L as compared to those required by bodyweight or glycemic matched rats (p < 0.001). No difference was noted between RYGB and SG with regard to initial efficacy. SG was however associated with higher food intake, weight regain and higher insulin requirements versus RYGB at study end (p < 0.05). Severe hypoglycemia occurred in several rats after RYGB. Conclusions: RYGB and SG significantly improved glycemic control in a rodent model of advanced T2DM. Whilst short-term outcomes are similar, long-term efficacy appears marginally better after RYGB although this is tempered by the increased risk of hypoglycemia.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Integrative Human Physiology
05 Vetsuisse Faculty > Institute of Veterinary Physiology
05 Vetsuisse Faculty > Institute of Laboratory Animal Science
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:15 February 2015
Deposited On:03 Feb 2015 15:44
Last Modified:05 Apr 2016 18:45
Publisher:American Physiological Society
ISSN:0363-6119
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1152/ajpregu.00331.2014
PubMed ID:25540099

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