Utzschneider, Kristina M.Ehrmann, David A.Arslanian, Silva A.Barengolts, ElenaBuchanan, Thomas A.Caprio, SoniaEdelstein, Sharon L.Hannon, Tamara S.Kahn, Steven E.Kozedub, AlexandraMather, Kieren J.Nadeau, Kristen J.Sam, SusanTripputi, MarkXiang, Anny H.El ghormli, LaureThe RISE Consortium2024-06-102024-06-102022Utzschneider KM, Ehrmann DA, Arslanian SA, et al. Weight loss and β-cell responses following gastric banding or pharmacotherapy in adults with impaired glucose tolerance or type 2 diabetes: a randomized trial. Obesity (Silver Spring). 2022;30(8):1579-1588. doi:10.1002/oby.23475https://hdl.handle.net/1805/41306Objective: The extent to which weight loss contributes to increases in insulin sensitivity (IS) and β-cell function after surgical or medical intervention has not been directly compared in individuals with impaired glucose tolerance or newly diagnosed type 2 diabetes. Methods: The Restoring Insulin Secretion (RISE) Study included adults in the Beta-Cell Restoration Through Fat Mitigation Study (n = 88 randomized to laparoscopic gastric banding or metformin [MET]) and the Adult Medication Study (n = 267 randomized to placebo, MET, insulin glargine/MET, or liraglutide + MET [L + M]). IS and β-cell responses were measured at baseline and after 12 months by modeling of oral glucose tolerance tests and during arginine-stimulated hyperglycemic clamps. Linear regression models assessed differences between and within treatments over time. Results: BMI decreased in all treatment groups, except placebo, at 12 months. IS increased in all arms except placebo and was inversely correlated with changes in BMI. L + M was the only treatment arm that enhanced multiple measures of β-cell function independent of weight loss. Insulin secretion decreased in the laparoscopic gastric banding arm proportional to increases in IS, with no net benefit on β-cell function. Conclusions: Reducing demand on the β-cell by improving IS through weight loss does not reverse β-cell dysfunction. L + M was the only treatment that enhanced β-cell function.en-USPublisher Policyinsulin sensitivity (IS)β-cell functiontype 2 diabetesArticle