<b>Effects of marked weight loss induced by gastric bypass surgery or low-calorie diet alone on postprandial glucose disposal in type 2 diabetes</b>

<p dir="ltr">We used a dual (intravenous and oral) glucose tracer protocol to evaluate rates of glucose appearance into the circulation, insulin-mediated glucose disposal (IMGD), and non-insulin-mediated glucose disposal (NIMGD) for four hours after consumption of a mixed meal in people with obesity and type 2 diabetes before and after marked (~20%) weight loss, induced by behavioral diet therapy (BDT, n=11) or Roux-en-Y gastric bypass (RYGB) surgery (n=9).<a href="" target="_blank"> Total postprandial glucose appearance rate was lower after compared with before weight loss in both the BDT and RYGB groups because of a decrease in endogenous glucose production, without a difference between groups. </a><a href="" target="_blank">However, the decreases </a>in total and incremental postprandial plasma glucose concentration areas-under-the-curve were greater in the BDT group than the RYGB group because IMGD doubled in the BDT group but did not change in the RYGB group. These results demonstrate that the improvement in postprandial glycemia is greater after marked, matched weight loss induced by BDT compared with RYGB in people with obesity and type 2 diabetes because of increased IMGD after BDT but not RYGB. Nonetheless, these findings do not diminish the potent therapeutic effect of RYGB surgery on glycemic control and even achieving remission of type 2 diabetes.</p>