Main > A1. CORP. INDEX. Cn-Cz > Cornell University/P C2 > Weill Cornell Medical College C2 > 2008. 03.07.2008. Diabetes Surgery
Author pointed to the small bowel as the possible site of critical mechanisms for the development of diabetes.
Clinical studies have shown that procedures that restrict the stomach s size ie, gastric banding improve diabetes only by inducing massive weight loss.
By studying diabetes in animals, Dr Rubino has provided scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (ie, gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese.
'By answering the question of how diabetes surgery works, we may be answering the question of how diabetes itself works,' Sciencedaily quoted him as saying.
'When we bypass the duodenum and jejunum, we are bypassing what may be the source of the problem,' said Dr Rubino, who is heading the NewYork-Presbyterian/Weill Cornell s Diabetes Surgery Center.
In fact, it has become increasingly evident that the gastrointestinal tract plays an important role in energy regulation, and that many gut hormones are involved in the regulation of sugar metabolism.
'It should not surprise anyone that surgically altering the bowel s anatomy affects the mechanisms that regulate blood sugar levels, eventually influencing diabetes,' Dr Rubino said.
'When performed in subjects who were not diabetic, the bypass of the upper intestine may even impair the mechanisms that regulate blood levels of glucose,' he added.
In striking contrast, when nutrients passage is diverted from the upper intestine of diabetic patients, diabetes resolves, he pointed out.
This, he explained, implies that the upper intestine of diabetic patients may be the site where an abnormal signal is produced, causing, or at least favoring, the development of the disease.
'In healthy patients, a correct balance between incretin and anti-incretin factors maintains normal excursions of sugar levels in the bloodstream,' he further explained.
'In some individuals, the duodenum and jejunum may be producing too much of this anti-incretin, thereby reducing insulin secretion and blocking the action of insulin, ultimately resulting in Type 2 diabetes,' he added.
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