Improved β-cell function seems to be essential for better glucose homeostasis after Roux-en-Y gastric bypass but is less studied after sleeve gastrectomy (SG). We evaluated the effects of SG on β- cell function in obese patients with diabetes (DM group) and without (Control group) in response to both oral and intravenous glucose stimulation. The DM group demonstrated impaired insulin sensitivity and insulin response to glucose before surgery. The insulin sensitivity index of both groups significantly improved after SG. In addition, the insulin response to glucose (early insulinogenic index in OGTT and AIRglu in IVGTT) increased in the DM group but decreased in the Control group. As a result, β-cell function improved significantly in both groups after SG since the disposition index (DI) increased in both. However, the DI of DM group still can’t restore to the level of Control group up to 1 year after SG. Our results support that both obese patients with and without diabetes could benefit from SG in β-cell function. For obese patients at risk of or have been diagnosed with diabetes, interventions should be recommended early to preserve or restore β-cell function, and SG could be an effective choice. Further studies are needed for long-term effects.

中文翻译：

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患有或不患有糖尿病的肥胖患者袖状胃切除术后的β细胞功能和胰岛素动态


改善 β 细胞功能似乎对于 Roux-en-Y 胃绕道手术后更好的葡萄糖稳态至关重要，但在袖状胃切除术 (SG) 后研究较少。我们评估了 SG 对患有糖尿病的肥胖患者（DM 组）和没有糖尿病的肥胖患者（对照组）的 β 细胞功能的影响，以响应口服和静脉注射葡萄糖刺激。糖尿病组在手术前表现出胰岛素敏感性和胰岛素对葡萄糖的反应受损。 SG后两组胰岛素敏感性指数均显着改善。此外，DM 组对葡萄糖的胰岛素反应（OGTT 中的早期胰岛素生成指数和 IVGTT 中的 AIRglu）增加，但对照组则降低。结果，SG 后两组的 β 细胞功能均显着改善，因为两组的处置指数 (DI) 均有所增加。然而，SG后1年，DM组的DI仍不能恢复到对照组的水平。我们的结果支持肥胖患者无论是否患有糖尿病都可以从 SG 的 β 细胞功能中受益。对于有糖尿病风险或已诊断为糖尿病的肥胖患者，应尽早建议采取干预措施以保留或恢复 β 细胞功能，而 SG 可能是一个有效的选择。需要进一步研究长期影响。