| Title |
Changes in Insulin Resistance Following Bariatric Surgery: Role of Caloric Restriction and Weight Loss
|
|---|---|
| Published in |
Obesity Surgery, April 2005
|
| DOI | 10.1381/0960892053723367 |
| Pubmed ID | |
| Authors |
Andrew A Gumbs, Irvin M Modlin, Garth H Ballantyne |
| Abstract |
The prevalence of type 2 diabetes mellitus (T2DM) and obesity in the western world is steadily increasing. Bariatric surgery is an effective treatment of T2DM in obese patients. The mechanism by which weight loss surgery improves glucose metabolism and insulin resistance remains controversial. In this review, we propose that two mechanisms participate in the improvement of glucose metabolism and insulin resistance observed following weight loss and bariatric surgery: caloric restriction and weight loss. Nutrients modulate insulin secretion through the entero-insular axis. Fat mass participates in glucose metabolism through the release of adipocytokines. T2DM improves after restrictive and bypass procedures, and combinations of restrictive and bypass procedures in morbidly obese patients. Restrictive procedures decrease caloric and nutrient intake, decreasing the stimulation of the entero-insular axis. Gastric bypass (GBP) operations may also affect the entero-insular axis by diverting nutrients away from the proximal GI tract and delivering incompletely digested nutrients to the distal GI tract. GBP and biliopancreatic diversion combine both restrictive and bypass mechanisms. All procedures lead to weight loss and decrease in the fat mass. Decrease in fat mass significantly affects circulating levels of adipocytokines, which favorably impact insulin resistance. The data reviewed here suggest that all forms of weight loss surgery lead to caloric restriction, weight loss, decrease in fat mass and improvement in T2DM. This suggests that improvements in glucose metabolism and insulin resistance following bariatric surgery result in the short-term from decreased stimulation of the entero-insular axis by decreased caloric intake and in the long-term by decreased fat mass and resulting changes in release of adipocytokines. Observed changes in glucose metabolism and insulin resistance following bariatric surgery do not require the posit of novel regulatory mechanisms. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 125 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | <1% |
| India | 1 | <1% |
| France | 1 | <1% |
| Unknown | 122 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 21 | 17% |
| Researcher | 20 | 16% |
| Student > Bachelor | 19 | 15% |
| Student > Ph. D. Student | 15 | 12% |
| Student > Doctoral Student | 7 | 6% |
| Other | 22 | 18% |
| Unknown | 21 | 17% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 59 | 47% |
| Agricultural and Biological Sciences | 15 | 12% |
| Biochemistry, Genetics and Molecular Biology | 11 | 9% |
| Nursing and Health Professions | 4 | 3% |
| Psychology | 3 | 2% |
| Other | 12 | 10% |
| Unknown | 21 | 17% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 January 2020.
All research outputs
#2,271,237
of 22,716,996 outputs
Outputs from Obesity Surgery
#220
of 3,364 outputs
Outputs of similar age
#3,817
of 59,927 outputs
Outputs of similar age from Obesity Surgery
#2
of 19 outputs
Altmetric has tracked 22,716,996 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,364 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.4. This one has done particularly well, scoring higher than 93% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 59,927 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 89% of its contemporaries.