Diabetes Cured? - the Surgery that Stops Diabetes

Today, this reporter, a diabetic, was astonished to learn that there is, in fact, an effective surgical option and cure for Type II Diabetes. Dr. Francesco Rubino of New York Presbyterian Hospital/Weill Cornell Medical Center, points to the small bowel as the possible future of diabetes research and care. In clinical studies, he has been the first to be able to show that gastric bypass surgery, independent of weight loss, can result in diabetes remission. Dr. Steven Garner of the New York Methodist Hospital says, in a Fox News report, "It's a cure but we're not advanced enough yet in the number of studies we've done. But, it's a whole different way to look at diabetes. Instead of looking at that your blood sugar is too high and give insulin or pills to make it go down, we're now looking and found that the duodenum or the small bowel... the first foot of this is what controls the diabetes apparently. What controls glucose mechanism." Dr. Rubino's research has shown that the mechanism allowing gastric bypass to control diabetes relies specifically on the duodenum and jejunum. "When we bypass the duodenum and jejunum, we are bypassing what may be the source of the problem.", reports Dr. Rubino. While this procedure will not improve the bodies ability to regulate blood sugar and can even be harmful to the blood sugar regulation ability of a non diabetic, for the diabetic, according to Dr. Steven Garner, those receiving surgery bypassing this upper intestinal area, "... they get better the next day." It is important to note that other doctors may state a matter of days to a month for the remission to occur.

Dr. Steven Garner also notes that some doctors are bypassing the first foot of the small intestine by inserting a plastic tube by way of a patient's throat. This practice is a creative non-surgical option providing the same prevention of nutrient interaction with the duodenum and jejunum. However, some treatable vomiting may result as a side effect.

There is still an immense mystery to be solved as to what role the intestine plays in diabetes. Dr. Rubino surmises, "In healthy patients, a correct balance between incretin [Gastrointestinal hormones intended to boost insulin production as nutrients make transit through the intestines] and anti-incretin [theorized] factors maintains normal excursions of sugar levels in the bloodstream.", and, "In some individuals, the duodenum and jejunum may be producing too much of this anti-incretin, thereby reducing insulin secretion and blocking the action of insulin, ultimately resulting in Type 2 diabetes." He believes that furthering this research may bring about greater knowledge of the cause of diabetes. He also advocates increasing the surgical option's availability to diabetic patients. He states, "It has become clear, however, that BMI cut-offs can no longer be used to determine who is an ideal candidate for surgical treatment of diabetes.", and, "There is, in fact, growing evidence that diabetes surgery can be effective even for patients who are only slightly obese or just overweight. Clinical trials in this field are therefore a priority as they allow us to compare diabetes surgery to other treatment options in the attempt to understand when the benefits of surgery outweigh its risks. Clinical guidelines for diabetes surgery will certainly be different from those for bariatric surgery, and should not be based only on BMI levels."

According to Dr. Rubino, there is a whole new future beyond simply regulating diabetes. He asserts, "The lesson we have learned with diabetes surgery is that diabetes is not always a chronic and relentless disease, where the only possible treatment goal is just the control of hyperglycemia and minimization of the risk of complications. Gastrointestinal surgery offers the possibility of complete disease remission. This is a major shift in the way we consider treatment goals for diabetes. It is unprecedented in the history of the disease."

References:
Article: ScienceDaily.com - http://www.sciencedaily.com/releases/2008/03/080305113659.htm
Article: Fox News - http://www.foxnews.com/wires/2008Jan24/0,4670,DiabetesObesitySurgery,00.html
Broadcast: Fox News - http://search2.foxnews.com/search?access=p&getfields=*&sort=date%3AD%3AS%3Ad1&output=xml_no_dtd&ie=UTF-8&client=my_frontend&filter=0&site=video&proxystylesheet=my_frontend&q=diabetes%20cure#