Surgery for Type 2 Diabetes?

Robert W. Griffith, MD

I don't usually write about exciting animal experiment results , or when only a few patients have responded to an experimental therapy. However, a short report at the American Association of Clinical Endocrinologists meeting was so intriguing that it's worth mentioning here. Foster-Schubert of Seattle, Washington, described results from Europe in two patients with type 2 diabetes who were treated by a sort of bariatric procedure. ( Bariatric surgery is the term used for gastric bypass surgery for severe obesity.)

In the surgery, a 10 - 20 cm length of the ileum (small intestine) was transposed, complete with its blood supply, into the duodenum - the first part of the intestine, just after the stomach. With this procedure there was no loss of intestinal absorption, so there was no nutritional deficiency. But, as with other bariatric procedures, there was an increased secretion of two proteins that affect feelings of fullness ( peptide YY) and the number of beta cells ( GLP-1), which results in more available insulin.

The HbA1c in both patients fell to normal (below 7%) in spite of a slight increase in BMI in one patient - BMI was unchanged in the other. If these results can be reproduced in a more patients (many more) the surgery may become a standard procedure for treating unmanageable type 2 diabetes - a wonderful advance.

Source
HealthandAge Blog

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