Original title: Effects of Ingestion Routes on Hormonal and Metabolic Profiles in Gastric-Bypassed Humans. Reference: Andreas Lindqvist, Peter Spégel, Mikael Ekelund, Hindrik Mulder, Leif Groop, Jan Hedenbro and Nils Wierup. . JCEM, 2013 DOI: 10.1210/jc.2012-3996.
A team of researchers at Lund University has explained why gastric bypass often sends diabetes to fast remission, which could be a step further towards finding a treatment with the same effect. 85% of patients with diabetes type 2 undergoing gastric bypass recover within a few days and show normal levels of blood sugar -long before they lose any weight. Until now, this phenomenon had not been explained.
“Most previous studies have analyzed samples taken from patients before and after a gastric bypass, but there is a risk that the results are misleading. They may not be attributable to the operation itself, but rather to factors such as weight loss and reduced food intake”, says Nils Wierup of the Lund University Diabetes Centre in Sweden. In a gastric bypass, food bypasses most of the stomach and duodenum. Only a small part of the upper stomach is connected directly to the small intestine. In some cases, the surgeon will insert a catheter into the part of the stomach that no longer has contact with food as a precautionary measure. This was what gave researchers the opportunity to study the exact difference in food intake before and after the procedure.
Participants were given a certain amount of a nutritional drink and blood samples were obtained before, during and, at brief intervals, after ingestion. The next step was to inject the same volume of nutritious mix through the catheter over the same length of time as it had taken the patient to drink it and the same samples were taken. This mix was then received where it would have been before gastric bypass.
The comparison revealed a major difference. “When the patient drank the solution, insulin blood levels rose almost five times as much as when it was injected into the closed off stomach. Intestinal hormones, which play a significant role in controlling blood sugar levels, rose sharply, as did certain amino acids. There was also a major impact on blood lipids, with the levels roughly halved”, says Nils Wierup, observing: “We believe these changes are part of the answer to why gastric bypass cures type 2 diabetes. We have looked at just a few intestinal hormones. There may be a hundred or more involved in the body’s complex sugar metabolism.” Jan Hedenbro, one of the surgeons in the study, adds: “If we can identify the mechanism behind this, it will open the way for both more individually tailored operations and, in the long run, the possibility of achieving the same results with pills rather than with surgery.”
Source: Medcenter.com,the leading portal in Latin America
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