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Stomach-bypass surgery cures diabetes in rats
By Karla Gale
NEW YORK (Reuters Health) - In rats, a weight loss operation, called
gastrojejunal bypass, can cure a type of diabetes often associated
with obesity, French researchers report. The operation works even
in animals that aren't fat.
Exactly why the surgery cures diabetes is a mystery. "If we
understand why the operation works, we might understand better the
cause of the disease," co-investigator Dr. Francesco Rubino
told Reuters Health. "Our ultimate goal is to develop a more
targeted approach to treatment of diabetes."
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: Annals of Surgery, January 2004.
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