Bariatric surgery, formerly used only for treating obesity, is being explored as a cure for type 2 diabetes in normal weight or moderately overweight people.
A recent analysis of 22,094 patients showed that 84 percent who underwent Roux-en-Y gastric bypass (RYGB) experienced complete reversal of their type 2 diabetes. Most of them stopped their oral meds or insulin before they even left the hospital.
Researchers initially thought that weight loss caused the remission of type 2, but new findings are pointing to hormonal and metabolic changes caused by the surgery. Ghrelin, a peptide that stimulates appetite, is decreased after bypass surgery. Other peptides secreted by intestinal cells, including glucagon-like peptide 1 (GLP-1), increase after the operation. (GLP-1 is the protein that Byetta mimics.)
Recently, the RYGB procedure was used on two mildly overweight patients. Within a month post-surgery, these patients had dramatically lower fasting glucose, fasting insulin, and A1c’s.
Specific recommendations regarding the audience for this surgery are due out this summer. The researchers believe that a bit of a turf war may consequently develop between endocrinologists and bariatric surgeons, who have their eye on type 2s as a potential market for surgical procedures.
Source: Medscape Medical News
Amercian Association of Clinical Endocrinologists