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Insulin secretion post-bypass may explain T2DM resolution

Study may help identify new treatments for T2DM in the future
Nils Wierup

Insulin-producing beta cells increase in number and performance after the gastric bypass and could explain why patients recover from their type 2 diabetes within days of surgery before any weight loss has taken place, researchers from Lund University Diabetes Centre in Sweden claim.

"We have suspected this for a while, but there have not previously been any models to prove it", said lead researcher, Dr Nils Wierup. "However, we are first going to repeat the study on pigs with obesity and diabetes.”

To gain insight into the mechanism of type 2 diabetes resolution, they investigated the effects of bypass on ß-cell function and ß-cell mass in the pig,

The results, published in the Diabetes, showed neither weight loss nor reduced food intake are required in order for the procedure to raise the number of beta cells, as the pigs had identical body weight and ate exactly the same amount of food.

They said that the bypass pigs (as compared to sham pigs) displayed improved glycaemic control, which was attributed to increases in ß-cell mass, islet number and number of extra-islet ß-cells. Pancreatic expression of insulin and glucagon was elevated, and cells expressing the GLP-1-receptor were more abundant in bypass-pigs.

"The reason why we have now studied pigs is that they are omnivores like us and their gastrointestinal physiology is similar to that of humans,” said Dr Jan Hedenbro, a surgeon at Aleris Obesitas, who has collaborated with Lund University Diabetes Centre on the project. “This basic research in GI tract functions is mutually beneficial, since it also helps the further refinements of surgical methods.”

The group, who have previously studied the effects of gastric bypass on humans, hope that the findings could lead to new methods of treatment for type 2 diabetes in the future.

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