In a weight loss operation, called gastrojejunal bypass, diabetes associated with obesity can often be cured.

Exactly why the surgery cures diabetes is a mystery. In obese patients with diabetes, gastrojejunal bypass is associated with improved sugar control, "long before significant weight loss" occurs, Rubino and Dr. Jacques Marescaus point out in the Annals of Surgery. They theorize that changes in how the gut interacts with insulin might explain the surgery's direct anti-diabetic effect.

To investigate this possibility, the surgeons, both at Louis Pasteur University in Strasbourg, performed gastrojejunal bypass or a fake operation in non-obese rats with diabetes.

After surgery, the two groups had the same average daily food intake and similar weight gain profiles. In animals that underwent bypass, sugar and insulin control improved dramatically. In contrast, no such effects were observed in rats treated with the fake operation.

In fact, bypass surgery was more effective than certain drugs or food restriction at controlling sugar levels.

"The operation by itself is anti-diabetic," Rubino said. "The result is not a secondary outcome of weight loss or decreased food intake."

He said he believes that in the future, the indication for bypass surgery will be widened to include patients whose diabetes is not easily controlled with diet or drugs, even if they are not obese.

Source: Diabetes In Control.com: Annals of Surgery, January 2004.

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