Evidence mapPaperPMID 25204975Full record

ArticleDiabetes2015

GLP-1 plays a limited role in improved glycemia shortly after Roux-en-Y gastric bypass: a comparison with intensive lifestyle modification.

Marion L Vetter, Thomas A Wadden, Karen L Teff, Zahra F Khan, Raymond Carvajal, Scott Ritter, Reneé H Moore, Jesse L Chittams, Alex Iagnocco, Kenric Murayama and 3 more

Open access · bronzeAbstract read
In one paragraph

Article in Diabetes, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 1 pooled it
8.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.

  1. Physiologic Mechanisms of Type II Diabetes Mellitus Remission Following Bariatric Surgery: a Meta-analysis and Clinical Implications.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
    Pooled it
  2. Trial
  3. Lixisenatide Reduces Chylomicron Triacylglycerol by Increased Clearance.The Journal of clinical endocrinology and metabolism · 2019
    Trial
  4. Trial
  5. Article
  6. Review
  7. Article
  8. Article
  9. Review
  10. Gastrointestinal peptides in eating-related disorders.Physiology & behavior · 2021 · on this map
    Review
  11. Intravital imaging of islet CaNature communications · 2021
    Article
  12. Diabetes Remission After Gastric Bypass: To Be or Not to Be Dependent on Weight Loss.The Journal of clinical endocrinology and metabolism · 2021
    Article
  13. Review
  14. Review
  15. Review
  16. Review
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Marion L VetterDepartment of Medicine, Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA Department of Psychiatry, Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA marion.vetter@bms.com.
Thomas A WaddenDepartment of Psychiatry, Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Karen L TeffMonell Chemical Senses Center, Philadelphia, PA.
Zahra F KhanDepartment of Medicine, Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Raymond CarvajalDepartment of Psychiatry, Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Scott RitterDepartment of Psychiatry, Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Reneé H MooreDepartment of Statistics, North Carolina State University, Raleigh, NC.
Jesse L ChittamsUniversity of Pennsylvania School of Nursing, Philadelphia, PA.
Alex IagnoccoDepartment of Statistics, North Carolina State University, Raleigh, NC.
Kenric MurayamaDepartment of Surgery, Division of Bariatric Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Gary KorusDepartment of Surgery, Division of Bariatric Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Noel N WilliamsDepartment of Surgery, Division of Bariatric Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Michael R RickelsDepartment of Medicine, Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
University of Pennsylvania · USNorth Carolina State University · USMonell Chemical Senses Center · US

Funding

Univ of Pennsylvania Diabetes Endocrinology Res CTRP30DK019525 · UNIVERSITY OF PENNSYLVANIA · 1986 to 2025
$10.9M
Physiology CoreP30DK020595 · UNIVERSITY OF CHICAGO · 2025 to 2025
$1.4M
NCRR NIH HHS KL2 RR024132NCRR NIH HHS KL2RR024132NCRR NIH HHS UL1 RR024134NCRR NIH HHS UL1RR024134NIDDK NIH HHS P30 DK019525NIDDK NIH HHS P30 DK020595NIDDK NIH HHS P30DK19525
6 · The paper itself

Abstract

Rapid glycemic improvements following Roux-en-Y gastric bypass (RYGB) are frequently attributed to the enhanced GLP-1 response, but causality remains unclear. To determine the role of GLP-1 in improved glucose tolerance after surgery, we compared glucose and hormonal responses to a liquid meal test in 20 obese participants with type 2 diabetes mellitus who underwent RYGB or nonsurgical intensive lifestyle modification (ILM) (n = 10 per group) before and after equivalent short-term weight reduction. The GLP-1 receptor antagonist exendin(9-39)-amide (Ex-9) was administered, in random order and in double-blinded fashion, with saline during two separate visits after equivalent weight loss. Despite the markedly exaggerated GLP-1 response after RYGB, changes in postprandial glucose and insulin responses did not significantly differ between groups, and glucagon secretion was paradoxically augmented after RYGB. Hepatic insulin sensitivity also increased significantly after RYGB. With Ex-9, glucose tolerance deteriorated similarly from the saline condition in both groups, but postprandial insulin release was markedly attenuated after RYGB compared with ILM. GLP-1 exerts important insulinotropic effects after RYGB and ILM, but the enhanced incretin response plays a limited role in improved glycemia shortly after surgery. Instead, enhanced hepatic metabolism, independent of GLP-1 receptor activation, may be more important for early postsurgical glycemic improvements.

Indexed as

Gastric BypassAdultBlood GlucoseFemaleGlucagon-Like Peptide 1HumansIncretinsInsulinInsulin ResistanceLife StyleMaleMiddle AgedObesityBlood GlucoseGlucagon-Like Peptide 1IncretinsInsulin

Identifiers

PMID25204975
PMCPMC4392925
OpenAlexW2101709187

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.