Studies have shown that gastric bypass surgery controls diabetes quickly, when compared to lap band surgery for weight loss. Until now, scientists weren’t exactly certain why gastric bypass affected diabetes more positively than lap band surgery. A new study suggests that changes in the intestines are responsible for better control of diabetes symptoms following the surgery.
The report, published in Cell Magazine, explains the identification of a new pathway for glucose production in the intestine. According to Gilles Mithieux (Institut National de la Sante et de la Recherche Medicale in France), gastric bypass surgery produces a “double intestine” after a portion of the stomach is removed. The surgery involves removing two-thirds of the stomach and upper intestine. When the lower part of the intestine is then attached to the stomach, it takes on characteristics of the absent upper portion of the intestine. Dr. Mithieux explains, "Up to now, the intestine had been considered like a machine to assimilate nutrients. We've now begun to realize that it is a complex endocrine organ" with particular importance when it comes to glucose metabolism.
The scientists found that when the intestine produces glucose, it signals the liver to stop manufacturing sugar. They also found that the intestine increases insulin sensitivity, also acting to lower blood sugar - changes that take place very soon after surgery. The findings may indicate that gastric bypass would be beneficial for diabetic patients who are not obese.
In order to understand the difference between gastric banding and gastric bypass, the researchers studied mice who had undergone both surgeries. The scientists observed that blood sugar, produced in the small intestine in proximity to the stomach, poured into the liver to be carried away, then synthesized. In the process, beneficial signals are sent to the brain that decrease hunger. Dr. Mithieux says, "The walls of the portal vein system detect the glucose and inform the brain." Gastric lap-banding however, does not affect the intestine in the same way.
Speak with your physician if you think you may be a candidate for weight-loss surgery. Your doctor will explain the benefits and risks of each surgery. The new information may bring added hope for reversing diabetes in insulin resistant patients.
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