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Allen et al. Theoretical Biology and Medical Modelling 2013, 10:45 http://www.tbiomed.com/content/10/1/RE SE A RCHOpen AccessMechanisms behind the immediate effects of Roux-en-Y gastric bypass surgery on type 2 diabetesRoland E Allen1,2* , Tyler D Hughes1 , Jia Lerd Ng1 , Roberto D Ortiz1 , Michel Abou Ghantous2 , Othmane Bouhali2 , Philippe Froguel3,4,5,6,7 and Abdelilah Arredouani3,*Correspondence: [email protected] 1 Department of Physics and Astronomy, Texas A M University, College Station, TX 77843, USA 2 Department of Physics, Texas A M University at Qatar, Education City, PO Box 23874, Doha, Qatar Full list of author information is available at the end of the articleAbstract Background: The most common bariatric surgery, Roux-en-Y gastric bypass, leads to glycemia normalization in most patients long before there is any appreciable weight loss. This effect is too large to be attributed purely to caloric restriction, so a number of other mechanisms have been proposed. The most popular hypothesis is enhanced production of an incretin, active glucagon-like peptide-1 (GLP-1), in the lower intestine. We therefore set out to test this hypothesis with a model which is simple enough to be robust and credible. Method: Our method involves (1) setting up a set of time-dependent equations for the concentrations of the most relevant PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25768400 species, (2) considering an “adiabatic” (or quasi-equilibrium) state in which the concentrations are slowly varying compared to reaction rates (and which in the present case is a postprandial state), and (3) solving for the dependent concentrations (of e.g. insulin and glucose) as an independent concentration (of e.g. GLP-1) is varied. Results: Even in the most favorable scenario, with maximal values for (i) the increase in active GLP-1 concentration and (ii) the effect of GLP-1 on insul.