Surgery To Cure Type 2 Diabetes?

Recent research has found that the small intestine might be responsible for the onset of Type 2 diabetes. If this turns out to be true, Type 2 diabetes might be operable, and will certainly be better understood.

Leading author and researcher Dr. Francesco Rubino of Cornell University recently published his findings, stressing that “By answering the question of how diabetes surgery works, we may be answering the question of how diabetes itself works.” Type 2 diabetes is characterized by the resistance of cells to insulin (“insulin resistance”), with the pancreas secreting an insufficient level of insulin to overcome this resistance. Type 2 diabetes accounts for over 90% of diabetes cases, amounting to over 200 million cases worldwide. The surgery suggested by Dr. Rubino that could send this resistance into remission is a bypass of the upper small intestine (the duodenum and jejunum).

Past research has shown that surgery restricting the stomachs size (“gastric banding”) can lead to some level of remission for Type 2 diabetes, but this is due primarily to the decrease in obesity, a condition closely connected to diabetes. Dr. Rubino’s research on the other hand is thought to be independent of obesity. By conducting surgery on the small intestines on various diabetic animals, Dr. Rubino found “scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (i.e., gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese.”

It is well known that the gastrointestinal tract is connected to many metabolic and subsequently blood sugar functions in the body. Performing surgery on the region, as has been done in the past by other researchers, changes and sometimes eliminates, the debilitating behavior of the disease. “It should not surprise anyone that surgically altering the bowel’s anatomy affects the mechanisms that regulate blood sugar levels, eventually influencing diabetes,” says Rubino.

In contrast to past techniques, Rubino’s does not control blood sugar level, but aims to get at the root of the diabetic problem by bypassing the upper small intestine. His research suggests that “the upper intestine of diabetic patients may be the site where an abnormal signal is produced, causing, or at least favoring, the development of the disease.” The signal referred to is that which regulates blood levels of glucose. So by bypassing the upper intestine in diabetic individuals, this abnormal signal could potentially be eliminated, causing the remission of Type 2 diabetes.

With cases of Type 2 diabetes growing worldwide, and the still poor understanding for how to treat it (and no accepted way how to cure it), Dr. Rubino’s unique research and technique could prove invaluable in the near future. If Type 2 diabetes is operable, as Rubino suggests, many cases could be put into remission, and with a better understanding of the origin of the disease, preventative tests and procedures for Type 2 diabetes could be performed.

Source: Defeat Diabetes Foundation: Rubino, Francesco. Weill Cornell Medical College Press Release. “Type 2 Diabetes May Be Caused by Intestinal Dysfunction.” March 2008.