Surgical Treatment May Cure Type 2 Diabetes

Newswise — Gastric bypass surgery, a well-established treatment for morbid obesity, may also cure Type 2 diabetes, even in individuals who are not overweight, according to a groundbreaking new study from IRCAD/The European Institute of Telesurgery being published in the January 2004 issue of the Annals of Surgery.

The antidiabetic effect of gastric bypass surgery in obese patients was first observed in 1982, and has since been affirmed by a more recent, large-scale study published in October of this year*. However, it remained unclear if this effect was secondary to the treatment of the obesity and subsequent weight loss or if the surgery actually had a direct effect on controlling Type 2 diabetes.

The authors of the current study, Dr. Francesco Rubino and Professor Jacques Marescaux, have now demonstrated, for the first time, that surgery to bypass the duodenum and jejunum controls Type 2 diabetes even when obesity is not present. The doctors performed the study in non-obese rats with naturally-occurring diabetes. They found that glucose levels in rats undergoing bypass surgery returned to normal after surgery compared to the same type of rats who did not have bypass surgery and whose diabetes worsened. This finding generates new hope for millions of people suffering from the disease, and may revolutionize traditional scientific thinking about diabetes.(*Phillip Schauer and colleagues, Annals of Surgery, October 2003)

Diabetes currently affects more than 150 million people worldwide and that number is expected to double by 2025. Over 90% of people with the disease have the Type 2 form which is associated with older age, obesity and overweight, lack of physical activity, and family history. Unlike Type 1 diabetes in which the pancreas fails to produce sufficient insulin, the pancreas in patients with Type 2 diabetes produces enough insulin, but for unknown reasons, the body is unable to use the insulin " a condition known as insulin resistance. Both types of diabestes can lead to blindess, heart and blood vessel disease, strokes, kidney failure, amputations, and nerve damage. In 2002, in the United States alone, the cost of treating diabetes and its consequences are an estimated $132 billion. Current therapies, which include diet, exercise, oral antidiabetic drugs and insulin, do not cure the disease.

The Annals of Surgery will feature the article by Rubino and Marescaux with an editorial written by Dr. Walter J. Pories, Professor of Surgery and Biochemistry at East Carolina University, Greenville, North Carolina, USA. Dr. Pories, who made the original 1982 observation connecting gastric bypass and diabetes, is world renowned for his expertise in surgery for obesity in diabetic patients. In emphasizing the relevance and implications of the work from Strasbourg, Dr. Pories writes:

"The elegant experiments of Rubino and Marescaux provide an ingenious answer to the puzzle and contribute to the evolution of a new paradigm."