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Details

Autor(en) / Beteiligte
Titel
Weight loss and β‐cell responses following gastric banding or pharmacotherapy in adults with impaired glucose tolerance or type 2 diabetes: a randomized trial
Ist Teil von
  • Obesity (Silver Spring, Md.), 2022-08, Vol.30 (8), p.1579-1588
Ort / Verlag
United States
Erscheinungsjahr
2022
Quelle
MEDLINE
Beschreibungen/Notizen
  • Objective The extent to which weight loss contributes to increases in insulin sensitivity (IS) and β‐cell function after surgical or medical intervention has not been directly compared in individuals with impaired glucose tolerance or newly diagnosed type 2 diabetes. Methods The Restoring Insulin Secretion (RISE) Study included adults in the Beta‐Cell Restoration Through Fat Mitigation Study (n = 88 randomized to laparoscopic gastric banding or metformin [MET]) and the Adult Medication Study (n = 267 randomized to placebo, MET, insulin glargine/MET, or liraglutide + MET [L + M]). IS and β‐cell responses were measured at baseline and after 12 months by modeling of oral glucose tolerance tests and during arginine‐stimulated hyperglycemic clamps. Linear regression models assessed differences between and within treatments over time. Results BMI decreased in all treatment groups, except placebo, at 12 months. IS increased in all arms except placebo and was inversely correlated with changes in BMI. L + M was the only treatment arm that enhanced multiple measures of β‐cell function independent of weight loss. Insulin secretion decreased in the laparoscopic gastric banding arm proportional to increases in IS, with no net benefit on β‐cell function. Conclusions Reducing demand on the β‐cell by improving IS through weight loss does not reverse β‐cell dysfunction. L + M was the only treatment that enhanced β‐cell function.

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