Stomach surgery may cure diabetes

2 September, 2007:

Stomach surgery, meant to help people who are severely obese lose weight, may cure the most common form of diabetes.

According to research conducted by an international team of scientists, doctors who performed the operation on obese diabetics noticed that in 98% of cases the condition disappeared a few weeks after surgery, which they said is too soon to be accounted for by weight loss.

The 40-minute duodenal exclusion operation removes the upper small intestine, leading to the stomach feeding directly into the small intestine, thus reducing the time the body has to absorb calories and resulting in weight loss.

However, one of the leading diabetes experts of the United Kingdom has urged caution, saying that surgery should be used only as a last resort.

A team of French, Italian, and Brazilian doctors operated on seven people with Type 2 diabetes who are of normal weight or moderately obese to test the results. Nine months after surgery, the first two patients no longer needed insulin injections. Both experienced dramatic reductions in their blood sugar and insulin levels in the month following surgery – before any weight loss took place.

It is still too soon to determine the effects on the remaining five patients, according to the findings of the research published in Surgery for Obesity and Related Diseases.

Dr Francesco Rubino, a surgeon at the Catholic University of Rome, 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 nutrients’ passage, is possibly exaggerated in diabetic patients or produced in an untimely fashion, disturbing the regulation of insulin and blood glucose levels,” Dr Rubino said.

In the opinion of Dr Iain Frame, research manager at Diabetes UK, “it is difficult to draw firm conclusions from this work. It is a very small study of seven people, with just two people having been followed up. Therefore, we don’t know exactly what is happening in these cases. One possible explanation is that the intake of food has been so drastically reduced that the small amount of insulin still produced by these people is able to cope in the short term. Either way, surgery should only ever be considered as a last resort.”