European scientists have shed new light on why gastric bypass often sends diabetes into remission rapidly, opening the door to developing treatments with the same effect.
Nils Wierup, from Lund University in Sweden, explained that 85 percent of patients with type 2 diabetes who undergo a gastric bypass procedure recover from the disease within a few days. Such patients show a return to normal blood sugar levels long before any weight loss occurs, but until now there have been few clues as to why this happens.
Wierup explained that in a gastric bypass, food bypasses the majority of the stomach and duodenum. Just a small part of the upper stomach is connected directly to the small intestine. In some cases, the surgeon inserts a catheter into the part of the stomach that no longer has contact with food as a precautionary measure. This was what gave the researchers an opportunity to study the exact difference between food intake before and after the procedure.
Participants in the study were given a set amount of a nutritional drink and blood samples were taken before, during and at short intervals after it was drunk. The next step was to inject the same amount of nutritional solution through the catheter over the same length of time as it had taken the patient to drink it and the same samples were taken. The food then ended up where it would have been before the gastric bypass.
The comparison revealed a major difference. "When the patient drank the solution, the insulin levels in the blood rose almost five times as much as when it was injected into the closed-off stomach. Intestinal hormones, which play a significant role in controlling blood sugar levels, rose sharply, as did certain amino acids. There was also a major impact on blood lipids, with the levels roughly halved," observed Wierup.
He believes these changes are part of the answer to why gastric bypass cures type 2 diabetes. "We have looked at just a few intestinal hormones. There may be a hundred or more involved in the body's complex sugar metabolism. If further research can identify the mechanism behind this, it will raise the possibility of achieving the same results with pills rather than with surgery."
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Source: Lund University