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Weight Loss Improves β-Cell Function in People With Severe Obesity and Impaired Fasting Glucose: A Window of Opportunity.

  • Rothberg, Amy E1, 2
  • Herman, William H1, 3
  • Wu, Chunyi1
  • IglayReger, Heidi B1
  • Horowitz, Jeffrey F4
  • Burant, Charles F1, 2
  • Galecki, Andrzej T1, 5
  • Halter, Jeffrey B1, 6
  • 1 Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
  • 2 Department of Nutritional Sciences, University of Michigan, Ann Arbor, Michigan.
  • 3 Department of Epidemiology, University of Michigan, Ann Arbor, Michigan.
  • 4 Department of Kinesiology, University of Michigan, Ann Arbor, Michigan.
  • 5 Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
  • 6 Institute of Gerontology, University of Michigan, Ann Arbor, Michigan.
Published Article
The Journal of Clinical Endocrinology & Metabolism
The Endocrine Society
Publication Date
Apr 01, 2020
DOI: 10.1210/clinem/dgz189
PMID: 31720686


In people with obesity, β-cell function may adapt to insulin resistance. We describe β-cell function in people with severe obesity and normal fasting glucose (NFG), impaired fasting glucose (IFG), and type 2 diabetes (T2DM), as assessed before, 3 to 6 months after, and 2 years after medical weight loss to describe its effects on insulin sensitivity, insulin secretion, and β-cell function. Fifty-eight participants with body mass index (BMI) ≥ 35 kg/m2 (14 with NFG, 24 with IFG, and 20 with T2DM) and 13 normal weight participants with NFG underwent mixed meal tolerance tests to estimate insulin sensitivity (S[I]), insulin secretion (Φ), and β-cell function assessed as model-based Φ adjusted for S(I). All 58 obese participants were restudied at 3 to 6 months and 27 were restudied at 2 years. At 3 to 6 months, after a 20-kg weight loss and a decrease in BMI of 6 kg/m2, S(I) improved in all obese participants, Φ decreased in obese participants with NFG and IFG and tended to decrease in obese participants with T2DM, and β-cell function improved in obese participants with NFG and tended to improve in obese participants with IFG. At 2 years, β-cell function deteriorated in participants with NFG and T2DM but remained significantly better in participants with IFG compared to baseline. Short-term weight loss improves β-cell function in participants with NFG and IFG, but β-cell function tends to deteriorate over 2 years. In participants with IFG, weight loss improves longer-term β-cell function relative to baseline and likely relative to no intervention, suggesting that obese people with IFG are a subpopulation whose β-cell function is most likely to benefit from weight loss. © Endocrine Society 2019.

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