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Wednesday, November 11, 2009
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Why Gastric Bypass Helps Diabetics

Ivanhoe Newswire Wednesday, Sep. 3, 2008; 4:15 AM

(Ivanhoe Newswire) -- New evidence explains why patients who undergo gastric bypass surgery get their diabetes symptoms under control quickly -- often within days -- while those who have lap-band surgery do not.

The key, researchers say, is the change in the position of the intestines. During gastric bypass surgery, the portion of the intestines closest to the stomach is removed so that it no longer receives nutrients. The lower portion is then attached directly to the stomach, thus receiving all of the incoming nutrients. Researchers say these positional changes "ramp up" production of blood sugar by the small intestines, which then send signals to the liver to decrease glucose production.

These changes in the intestines increase insulin sensitivity and lower blood sugar, thus improving the symptoms of diabetes often within days of surgery; well before any weight loss takes place. In contrast, gastric banding -- also called lap-band surgery -- causes weight loss by placing a prosthetic band around the stomach, cutting hunger. Researchers say because it does not alter the intestines at all, it lacks the immediate metabolic benefits of bypass.

Study author Gilles Mithieux of Institut National de la Sante et de la Recherche Medicale in France advises patients considering either surgery to talk to their doctor about the risks and benefits of the procedures. He says these results support the notion that gastric bypass could be an effective treatment for diabetes in obese patients and could even have potential for patients who are diabetic but are not obese.

SOURCE: Cell Metabolism, 2008

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