Figure 2.

Model of changes in β-cell function following RYGB. An inverse relationship between insulin secretion and insulin sensitivity exists in surgical and nonsurgical patients. This empirically derived relationship is generally interpreted as β-cell function adapting to meet the demands of increasing insulin sensitivity (with weight loss) or increasing insulin resistance (with weight gain). Nondiabetic persons have decreased insulin secretion after RYGB, as β-cell function is blunted to account for greater insulin action. In contrast, subjects with diabetes have improvements in both insulin secretion and insulin sensitivity. See (213, 214).