Surgeons performing duodenal exclusions on obese people with diabetes have noticed that in around 98 percent of cases, the patients' diabetes spontaneously vanished a few weeks after surgery.
According to a report in New Scientist on Monday, an international team of Italian, Brazilian and French doctors has performed duodenal exclusions on seven people with type 2 diabetes who were classified as being between normal weight and moderately obese. Nine months after surgery, the first two people they operated on are both free of anti-diabetic medication and both experienced dramatic reductions in their blood sugar and insulin levels in the month following surgery - before any weight loss took place. It is too soon to report on the other five patients.
Italian surgeon Francesco Rubino, involved in the study, believes that the duodenum may be the source of a signal that can ultimately cause insulin resistance.
"This molecular signal, which should be secreted in response to the passage of nutrients, is possibly exaggerated in diabetic patients or produced in an untimely fashion, disturbing the regulation of insulin and blood glucose levels," Rubino was quoted as saying.
If the assumption is correct, bypassing the duodenum could silence this "insulin resistance signal," thus re-establishing a normal balance between insulin and sugar, Rubina said.
According to Rubino, duodenal exclusions in people with diabetes who are not morbidly obese have also been performed by groups in Mexico, Peru, Dominican Republic and India with similar results, although the results have not been published.
Clinical trials are now starting in some of these countries as well as in China, Japan, the United States, Italy and Belgium, the report said.
Rubino and several other doctors have submitted a proposal to the American Association of Clinical Endocrinologists (AACE), suggesting it recommends the use of duodenal exclusion surgery to treat type 2 diabetes.
Type 2, or adult-onset, diabetes is characterized by insulin resistance, meaning the body can produce insulin - which would normally encourage liver and muscle cells to take up glucose from the blood - but cells no longer respond to it.
Source: Xinhua
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