Geltrude Mingrone, MD, PhD - Italy

Those bariatric operations bypassing the duodenum and the jejunum greatly improve up to normalize insulin resistance. We hypothesize that the duodenal/jejunal intestinal tract secretes hormone/s inducing insulin resistance in small amounts in healthy subjects and in progressive higher amounts in subjects with impaired glucose tolerance (IGT) and frank type 2 diabetes mellitus (T2DM).

As a proof of concept, we intend to study the response to a graded glucose isoglycemic infusion with a progressively increasing oral glucose load in subjects with a normal glucose tolerance (NGT) or with IGT or T2DM. The intent is to show a substantial reduction of the insulin mediated whole body glucose  uptake when glucose is given orally as compared with the isoglycemic intravenous administration route.

Stable isotopes (6,6-deuterated glucose infused intravenously and uniformly labeled 13C-glucose) will be administered in order to compute the oral glucose rate of appearance and the hepatic glucose output. Metabomic analyses will be performed.