OBJECTIVE
Research postprandial insulin secretion in the first phase in patients with obesity and type 2 diabetes mellitus in the early postoperative period during one anastomosis gastric bypass surgery.
MATERIAL AND METHODS
During the period from April 2019 to October 2019, 15 patients with obesity and type 2 diabetes mellitus were operated on and examined. The average age of the patients was 47±4.6 years, the body mass index was 48±5.3 kg/m2. All patients in our study underwent laparoscopic one anastomosis gastric bypass surgery. In order to assess postprandial insulin secretion in the first phase, the following laboratory complex was performed: determination of peripheral venous blood insulin on an empty stomach and 5 minutes after stimulation by an oral glucose-dependent incretinotropic test (taking a drink containing 24 grams of dry glucose). The studied parameters were evaluated before the operation and on the 3rd day after the surgical intervention.
RESULTS
During the study, there was a statistically significant (p<0.001) recovery of the first phase of insulin secretion or a tendency to its normalization was noted. Before the operation, the percentage of increase in the first phase relative to basal secretion was on average 114%, and on the 3-rd day after surgical treatment, this indicator increased to an average of 156%. At the same time, in all 15 patients, the quantitative index of insulin excreted basally decreased (p<0.02), averaging 24.3 µIU/ml before surgical treatment and on average 15.5 µIU/ml after it. We interpret this fact as compensation for hyperinsulinemia due to an early improvement in the sensitivity of peripheral tissues to insulin.
CONCLUSION
Laparoscopic one anastomosis gastric bypass helps to restore the peak of the first phase of insulin secretion on the third day after surgery. Also, based on this study, it can be concluded that already in the early stages after surgery, patients have a decrease in basal hyperinsulinemia. This fact demonstrates the effect of gastric bypass surgery with one anastomosis on insulin metabolism and the course of type 2 diabetes mellitus in obese patients, regardless of clinically significant body weight loss.
