Weight loss and β‐cell responses following gastric banding or pharmacotherapy in adults with impaired glucose tolerance or type 2 diabetes: a randomized trial
Year: 2022
Type: article
Study design: Clinical Trial
Abstract: 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.
Source: Obesity
DOI: 10.1002/oby.23475
Institutions: University of Washington, VA Puget Sound Health Care System, University of Chicago, University of Pittsburgh, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Jesse Brown VA Medical Center, Kaiser Permanente, Yale University, George Washington University, Indiana University Indianapolis, Indiana University School of Medicine, University of Colorado Anschutz
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: American Diabetes Association, U.S. Department of Veterans Affairs, Abbott Laboratories, Eli Lilly and Company, Novo Nordisk, National Institutes of Health, Allergan, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences
Awards: G1044130170, Enhancement of Beta Cell Function with Pharmacologic and Sleep Apnea Treatment, G1236451951, G129313595, G1474720215, G1673886231, G18062229, G215709867, G2192236676, G2337220457, Indiana Clinical and Translational Sciences Institute, G2739969157, RISE: The Restoring Insulin Secretion Pediatric Medication Study, G329278553, G3374716125, Preservation of Beta Cell Function in Prediabetes Early Type 2 Diabetes, The Next Generation of Innovative Cardiovascular Clinical/Translational Researchers, Optimizing Recovery and Preservation of Endogenous Insulin Secretion, G527537952, G66187487, G68878456, G801680829, G812494088, Beta Cell Restoration through Fat Mitigation, G898378059, University of Pittsburgh Clinical and Translational Science Institute, University of Colorado Anschutz Medical Campus DRC, J. NRSA Training Core, Diabetes Research Center, Yale Clinical and Translational Science Award, G904603239, G953027065
OpenAlex ID: W4288096716