Washington, Mar 6 : A new study by a leading expert in the emerging field of diabetes surgery has suggested that Type 2 diabetes may be caused by intestinal dysfunction, and that it may therefore be amenable to surgical treatment.
Dr. Francesco Rubino of NewYork-Presbyterian Hospital/Weill Cornell Medical Center, the study's author, has presented scientific evidence on the mechanisms of diabetes control after surgery.
Earlier clinical studies have shown that surgeries such as gastric banding that restrict the stomach's size improve diabetes only by inducing massive weight loss.
However, conducting a study on animals Dr. Rubino has provided the first scientific evidence that gastric bypass can improve diabetes independently of any weight loss, and even in subjects that are not obese.
"By answering the question of how diabetes surgery works, we may be answering the question of how diabetes itself works," says Dr. Rubino.
Earlier research done by Dr. Rubino has already shown that the primary mechanisms by which gastrointestinal bypass procedures control diabetes specifically rely on the bypass of the upper small intestine - the duodenum and jejunum.
This is a key finding that may point to the origins of diabetes.
"When we bypass the duodenum and jejunum, we are bypassing what may be the source of the problem," said Dr. Rubino.
"It should not surprise anyone that surgically altering the bowel's anatomy affects the mechanisms that regulate blood sugar levels, eventually influencing diabetes," he added.
Dr. Rubino's research shows that surgeries based on a bypass of the upper intestine may work by reversing abnormalities of blood glucose regulation.
This implies that the upper intestine of diabetic patients may be the site where an abnormal signal is produced, causing, or at least favouring, the development of the disease.
After gastrointestinal bypass procedures, the exclusion of the upper small intestine from the transit of nutrients may offset the abnormal production of anti-incretin, thereby resulting in remission of diabetes.
Dr. Rubino's article is published in a special supplement to the February issue of Diabetes Care.