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Efficacy for Gastric Bypass

The response to the hormone GLP-1 (glucagon-like-peptide 1), which is formed in the gastrointestinal tract, can predict the efficacy of a gastric bypass. GLP-1 sensitivity could therefore be used as a new ­biomarker for personalized therapeutic approaches in patients with type 2 ­diabetes and obesity.

Gastric bypass is one of the most frequently performed surgical procedures used to treat obesity and leads to a rapid loss of body weight in most patients. In addition, the surgical intervention induces an improved glucose metabolism – even before the weight loss. These metabolic improvements, however, vary considerably from patient to patient.A hormone test could possibly predict to what extent a gastric bypass would improve metabolism. Scientists led by Matthias Tschöp of the Institute for Diabetes and Obesity at Helmholtz Zentrum München and Kirk Habegger at the Metabolic Disease Institute of the University of Cincinnati discovered this using an animal mo­del. After gastric bypass surgery the concentration of the gut hormone GLP-1 (glucagon-like-peptide 1) in the blood rises significantly. GLP-1 increases insulin secretion and contributes to improved blood glucose levels and blood lipids. As the scientists led by Tschöp and Habegger showed, the efficacy of the secreted GLP-1 on blood glucose levels varies: the higher the sensitivity of the rats in the animal model to GLP-1, the more effective the gastric bypass. GLP-1 sensitivity could thus serve as a new predictive biomarker for personalized therapeutic approaches for type 2 diabetes and obesity. If the results are confirmed in the patient trials, the hormone response could be tested prior to a planned gastric bypass to determine to what extent the patient would benefit from the surgical procedure.

 

 

In a gastric bypass, only a small remnant of the stomach that holds about 15 ml remains. Furthermore, the upper small intestine is bypassed. The digestive juices are introduced into the deeper portions of the intestine where digestion begins. As a result, only part of the food is absorbed. The undigested food is conveyed into the large intestine.