Bariatric Surgery Reduces Oxidative Stress by Blunting 24-h Acute Glucose Fluctuations in Type 2 Diabetic Obese Patients
- Raffaele Marfella, MD, PHD1,
- Michelangela Barbieri, MD, PHD1,
- Roberto Ruggiero, MD2,
- Maria Rosaria Rizzo, MD, PHD1,
- Rodolfo Grella, MD, PHD1,
- Anna Licia Mozzillo, MD2,
- Ludovico Docimo, MD2 and
- Giuseppe Paolisso, MD, PHD1
- 1Department of Geriatrics and Metabolic Diseases, Second University of Naples, Naples, Italy;
- 2Department of Surgery, Second University of Naples, Naples, Italy.
- Corresponding author: Raffaele Marfella, raffaele.marfella{at}unina2.it.
Abstract
OBJECTIVE We evaluated the efficacy of malabsorptive bariatric surgery on daily blood glucose fluctuations and oxidative stress in type 2 diabetic obese patients.
RESEARCH DESIGN AND METHODS The 48-h continuous subcutaneous glucose monitoring was assessed in type 2 diabetic patients before and 1 month after biliopancreatic diversion (BPD) (n = 36), or after diet-induced equivalent weight loss (n = 20). The mean amplitude of glycemic excursions and oxidative stress (nitrotyrosine) were evaluated during continuous subcutaneous glucose monitoring. During a standardized meal, glucagon-like peptide (GLP)-1, glucagon, and insulin were measured.
RESULTS Fasting and postprandial glucose decreased equally in surgical and diet groups. A marked increase in GLP-1 occurred during the interprandial period in surgical patients toward the diet group (P < 0.01). Glucagon was more suppressed during the interprandial period in surgical patients compared with the diet group (P < 0.01). Mean amplitude of glycemic excursions and nitrotyrosine levels decreased more after BPD than after diet (P < 0.01).
CONCLUSIONS Oxidative stress reduction after biliopancreatic diversion seems to be related to the regulation of glucose fluctuations resulting from intestinal bypass.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received July 22, 2009.
- Accepted October 24, 2009.
- © 2010 by the American Diabetes Association.
