Bariatric surgery reduces oxidative stress by blunting 24-hours acute glucose fluctuations in type 2 diabetic obese patients
- Raffaele Marfella, MD, PhD (raffaele.marfella{at}unina2.it)1,
- 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, Italy
- 2Department of Surgery Second University of Naples
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- 48-h continuous subcutaneous glucose monitoring (CSGM) were assessed in type 2 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 (MAGE) and oxidative stress (nitrotyrosine) were evaluated during CSGM. During a standardized meal, glucagon-like peptide-1 (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 interprandial period in surgical patients toward diet group (P<0.01). Glucagon was more suppressed during interprandial period in surgical patients compared to diet group (P<0.01). MAGE and nitrotyrosine levels decreased more after GBP than after diet (P<0.01).
Conclusions Oxidative stress reduction after BPD seem to be related to the regulation of glucose fluctuations resulting from intestinal bypass.
Footnotes
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- Received July 22, 2009.
- Accepted October 24, 2009.
- Copyright © American Diabetes Association
