Background
Roux-en-Y Gastric bypass (GBP) often leads to diabetes resolution, even before weight loss, for reasons that are unclear. Experimental studies in relevant large animal model are needed to explore the responsible mechanisms. Here we explored in the minipig the respective role of the alimentary and common intestinal limbs of GBP on uptake of ingested sugars, and insulin and GLP-1 secretion.

Materials and Methods
Fourteen minipigs were submitted to GBP. Alternatively, a normal GBP (150 cm alimentary limb, n=7) or a long GBP (150 cm common limb, n=7) were constructed. Metabolic assessment was perfomed at baseline, 10 days and one month after surgery. In the N-GBP group, a laparotomy at one month and a clamp placed at distal part of the alimentary limb.

Results
L-GBP significantly increased weight loss in comparison with N-GBP at one month after the surgery. Insulin and GLP-1 secretions were increased at 10 days and 1 month after N-GBP. For L-GBP group the post prandial glucose and insulin excursion were lower than N-GBP group. D- xylose uptake after MM was significantly inferior in the L-GBP group than with the N-GBP group. During the clamp test, glucose, insulin and GLP-1 did not increase through the alimentary limb, and increased immediately after clamp removal, when meal reached common limb.

Conclusion
Meal sugar uptake occured only in the common limb, where it stimulated insulin and GLP-1 secretion. The length of the comon limb is critical for sugar uptake glucose.