Researchers observe new mechanism for diabetes resolution

July 25, 2013

Though existing research has shown gastric bypass surgery resolves type 2 diabetes, the reason has remained unclear. A research team, led by Nicholas Stylopoulos, MD, Boston Children's Hospital's Division of Endocrinology, has identified the small intestine—widely believed to be a passive organ—as the major contributor to the body's metabolism, based on a study in rats. The report will appear in Science on July 26, 2013.

Weight loss and improved diabetes often go hand-in-hand, but type 2 diabetes often gets resolved even before weight loss occurs after gastric bypass. To investigate why this happens, Stylopoulos and his team spent one year studying rats, and observed that after gastric bypass surgery, the small changes the way it processes glucose. The team saw the intestine using and disposing of glucose; thereby regulating blood glucose levels in the rest of the body and helping to resolve type 2 diabetes.

"We have seen type 2 diabetes resolve in humans after gastric bypass, but have never known why," says Stylopoulos. "People have been focusing on hormones, fat and muscle, but we have shown in this study that the answer lies somewhere in the most of the time."

Gastric bypass surgery, a weight loss treatment typically reserved for severely , reroutes food into the smaller pouch of the stomach and bypasses the rest of the stomach and . Before gastric bypass, intestines typically do not contain a specific transporter called GLUT-1, which is responsible for removing glucose from circulation and utilizing it within the organ. After gastric bypass, the researchers found that the intestine reprograms itself to contain GLUT-1, taking glucose from circulation and disposing of it, swiftly stabilizing in the rest of the body.

"Previously, we had not considered the intestine as a major glucose-utilizing organ. We have found this process is exactly what happens after surgery," says Stylopoulos.

Based on their findings, Stylopoulos and his colleagues found type 2 diabetes was resolved in 100 percent of the rats that underwent gastric bypass. Sixty-four percent of was resolved by the intestine, and the researchers hypothesize that the other 36 percent may be due to weight loss or other factors.

These findings pave the way for future investigations of how to create a medical pathway to mimic the intestine's reprogramming without the surgery. "With further research, we may find ways to bypass the bypass," says Stylopoulos. "The results of our study are promising because, unlike the brain and other organs, intestines are easily accessible. Furthermore, since cells in the intestine have such a short lifespan, we can easily study and pharmacologically manipulate them to use glucose, without long-term problems."

Explore further: Gastric bypass findings could lead to diabetes treatment

More information: "Reprogramming of Intestinal Glucose Metabolism and Glycemic Control in Rats After Gastric Bypass", Science vol 341 26 July 2013

Related Stories

Gastric bypass findings could lead to diabetes treatment

May 1, 2013
A Lund University research team has shed new light on why gastric bypass often sends diabetes into remission rapidly, opening the door to developing treatment with the same effect.

Bariatric surgery restores nerve cell properties altered by diet

June 17, 2013
Understanding how gastric bypass surgery changes the properties of nerve cells that help regulate the digestive system could lead to new treatments that produce the same results without surgery, according to Penn State College ...

Scientists reassess weight loss surgery for type 2 diabetes

January 4, 2012
Weight loss surgery is not a cure for type 2 diabetes, but it can improve blood sugar control, according to a new study published in the British Journal of Surgery. Whereas some previous studies have claimed that up to 80 ...

Bariatric surgical procedures have similar therapeutic benefits in obese adults

November 26, 2012
Obesity is associated with insulin resistance and type 2 diabetes, both of which can be significantly improved by weight loss. Gastric bypass and adjustable gastric banding are two bariatric surgery techniques that are frequently ...

Weight-loss surgery is new diabetes foe

January 4, 2013
(HealthDay)— Though it began as a treatment for something else entirely, gastric bypass surgery—which involves shrinking the stomach as a way to lose weight—has proven to be the latest and possibly most effective treatment ...

Recommended for you

In a nutshell: Walnuts activate brain region involved in appetite control

August 17, 2017
Packed with nutrients linked to better health, walnuts are also thought to discourage overeating by promoting feelings of fullness. Now, in a new brain imaging study, researchers at Beth Israel Deaconess Medical Center (BIDMC) ...

Smart mat detects early warning signs of foot ulcers

August 16, 2017
While completing his residency in anesthesiology at Massachusetts General Hospital in the mid-2000s, Jon Bloom saw his fair share of foot amputations among patients with diabetes. The culprit: infected foot ulcers.

The best place to treat type 1 diabetes might be just under your skin

August 14, 2017
A group of U of T researchers have demonstrated that the space under our skin might be an optimal location to treat type 1 diabetes (T1D).

New measure of insulin-making cells could gauge diabetes progression, treatment

August 10, 2017
Researchers at the University of Wisconsin-Madison have developed a new measurement for the volume and activity of beta cells, the source of the sugar-regulating hormone insulin.

Pioneering immunotherapy shows promise in type 1 diabetes

August 9, 2017
It may be possible to 'retrain' the immune system to slow the progression of type 1 diabetes, according to results of a clinical trial published today in the journal Science Translational Medicine.

Online team-based game helps patients with diabetes lower blood glucose

August 8, 2017
Researchers from Brigham and Women's Hospital and the Veterans Affairs Boston Healthcare System have found that an online, team-based game designed to teach patients about diabetes self-management had a sustained and meaningful ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.