Gut Hormone Test Predicts Efficacy of Gastric Bypass

Blood glucose was determined with a Freestyle Glucometer (Abbott Diabetes Care; Alameda, CA, USA).

Active and total GLP-1 was measured by electrochemiluminescence assay (Meso Scale Discovery; Gaithersburg, MD, USA). After gastric bypass surgery, the concentration of the gut hormone GLP-1 in the blood rises significantly. GLP-1 increases insulin secretion and contributes to improved blood glucose levels and blood lipids. In the rodent study, GLP-1 responsiveness varied considerably with regard to glucose metabolism and more importantly, the more responsive the animals were to GLP-1, the greater the efficacy of the gastric bypass turned out to be regarding glucose metabolism improvements.

The authors concluded that the GLP-1 system may offer untapped potential as a novel biomarker for personalized approaches to the treatment of type 2 diabetes (T2D) and obesity. Clinical studies in obese and T2D patients will be required to test if this desirable novel biomarker shows the same, or even greater, promise in humans and can be used to predict benefits, as well as to prevent unnecessary risks of bariatric surgeries.

Matthias H. Tschöp, MD, a professor and a senior author of the study said, “If our results are confirmed in clinical trials with patients, the hormone response could be tested before the planned surgery and surgeons would be able to predict how much an individual patient's glucose metabolism would benefit. This will contribute to the development of personalized therapies for type 2 diabetes and obesity. For surgical procedures such as gastric bypass this is particularly compelling because such operations are complex and cannot be easily reversed.” The study was published on November 1, 2013, in the journal Diabetes.

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