The effect of distal-ileal exclusion after Roux-en-Y gastric bypass on glucose tolerance and GLP-1 response in type-2 diabetes Sprague-Dawley rat model

Abstract Background An increase in glucagon-like peptide-1 (GLP-1) mediating early diabetes remission following Roux-en-Y gastric bypass (RYGB) is believed to be associated with distal-ileal stimulation. Objective To observe the effect of distal-ileal exclusion on glucose tolerance and GLP-1 response after RYGB. Setting Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China Method A type 2 diabetes model was created in 40 Sprague-Dawley rats that were randomly assigned to a Roux-en-Y gastric bypass group (RYGB, n = 32) and a sham group (n = 8). Four weeks after surgery, the RYGB group was further divided into the RYGB-control group (n = 8) and the distal-ileal exclusion group (RYGB-IEx, n = 24). Rats in the RYGB-IEx group underwent laparotomy, and the last 20 cm of ileum was excluded. An oral glucose tolerance test (OGTT), insulin tolerance test (ITT), and mixed-meal tolerance test (MMTT) conducted preoperatively were repeated in all groups at 4 and 8 weeks postoperatively. Results Compared with preoperative level, GLP-1 was significantly increased following RYGB. GLP-1 area under the curve (AUC) recorded following oral-gavage at week 4 postoperatively was significantly higher than the preoperative level (p Conclusion These findings suggest that distal-ileal stimulation might not be required for incretin response and diabetes remission following gastric bypass in the type 2 diabetes Sprague-Dawley rat model.