Adiposity is associated with prediabetes and type 2 diabetes. In very severe cases of adiposity in combination with type 2 diabetes, bariatric surgery has proven to be a successful therapy option. So far the molecular mechanisms that lead to an improvement of type 2 diabetes after bariatric surgery are not fully understood. It is planned to characterize the metabolic and neuroendocrine changes in subjects before and after bariatric surgery. One special focus of the study is brain insulin resistance, a condition known to be associated with obesity with impact on the brain and whole body metabolism.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
3
laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy
University of Tuebingen, Department of Internal Medicine IV
Tübingen, Germany
Central insulin sensitivity
Central insulin sensitivity will be assessed by fMRI after application of nasal insulin or placebo.
Time frame: Central insulin sensitivity will be assessed as change before bariatric surgery and 6 months afterwards.
Peripheral insulin sensitivity
Peripheral insulin sensitivity will be assessed by oral glucose tolerance test.
Time frame: Peripheral insulin sensitivity will be assessed by oral glucose tolerance as change before bariatric surgery and 6 months afterwards.
Whole body fat distribution
Body fat distribution will be assessed by MRI
Time frame: Body fat distribution will be assessed by MRI prior bariatric surgery and 6 months afterwards.
Liver fat content
Liver fat content will be assessed by MRS
Time frame: Liver fat content will be assessed by MRS prior bariatric surgery and 6 months afterwards.
Metabolic rate
Metabolic rate will be assessed by indirect calorimetry
Time frame: Metabolic rate will be assessed by indirect calorimetry prior bariatric surgery and 6 months afterwards.
Response to food cues
Food cues will be rated for palatability on a visual analogue scale
Time frame: Change in response to food cues will be assessed before bariatric surgery and 6 months afterwards.
Trail-making test
Trail-making test will be performed
Time frame: Change in trail-making test will be assessed before bariatric surgery and 6 months afterwards.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Hopkins-verbal learning test
Hopkins-verbal learning test will be performed
Time frame: Change in Hopkins-verbal learning test will be assessed before bariatric surgery and 6 months afterwards.
Glucose tolerance
Glucose tolerance will be assessed by 75g oral glucose tolerance test.
Time frame: Glucose tolerance will be assessed by 75g oral glucose tolerance test prior to bariatric surgery and 6 months afterwards.
Insulin secretion
Insulin secretion will be assessed by insulin measurements during 75g oral glucose tolerance test.
Time frame: Insulin secretion will be assessed by insulin measurements during 75g oral glucose tolerance test prior to bariatric surgery and 6 months afterwards.
Weight loss
Body weight will be measured before and 6 months after surgery.
Time frame: Weight loss before and 6 months after surgery.