A 40-minute operation, which claims to put an end to type 2 diabetes, has been taking the news by storm. Researches that have been conducted on animal studies have shown a great improvement in diabetes after the operation. Research is also being done currently on patients who have been long-term sufferers of type 2 diabetes. Some patients have shown to have a marked improvement in their condition with their glucose levels back to normal within four months of having had the surgery.

Diabetes Type 2 is a significant and growing health problem in the United Kingdom and also worldwide. There are just fewer than 1.9 million adults with diagnosed diabetes in the UK, and it is estimated another 589,000 are yet to be diagnosed. It is estimated that 5 per cent of adults in the UK have Type 2 diabetes. The risk increases with age with 10 per cent of those aged 75 and over diagnosed. There are also an estimated 33,000 diabetic-related deaths every year making it a cause for concern.^{1, 2} Hence any type of new treatment option, which helps to bring these statistics down, is a welcome idea.

The treatment, known as duodenal-jejunal exclusion or gastrojejunal bypass, involves bypassing part of the upper small intestine or duodenum, so that food from the stomach goes directly into the lower small intestine. The surgery appears to tackle the symptoms of Type 2 diabetes, although it is not yet clear how it works. Many theories have been put forth to how this works. One reason may be due to the reduction in the amount of food patients are able to digest. Another theory is that, as well as reducing food absorption; it may have an impact on the hormones involved in regulating food intake. Whatever seems to be the basis behind its success this novel treatment option has created a lot of excitement. One such study conducted by Francesco Rubino and his team in France shows whether the control of diabetes is a secondary outcome from the treatment of obesity or from the direct result of the operation in itself that both include³.

A gastrojejunal bypass (GJB) with preservation of an intact gastric volume was performed in 10- to 12-week-old non-obese rats with type 2 diabetes. Fasting glycaemia, oral glucose tolerance, insulin sensitivity, basal plasma insulin, and glucose-dependent-insulin tropic peptide as well as plasma levels of cholesterol, triglycerides, and free fatty acids were measured on the rats before and after the operation. The GJB was then compared with a control where rats underwent  marked food restriction, and medical therapy. The rats were then observed for 36 weeks after surgery. GJB improved glucose tolerance markedly in comparison with the control. GJB resulted also in better glycaemic control than greater weight loss from food restriction and than medical therapy. This thus shows that the bypass of duodenum and jejunum can directly control type 2 diabetes and not secondarily to the treatment of obesity, suggesting that surgery could also achieve glycaemic control in non-morbidly obese subjects as well. This thus supports the idea that an operation can be performed for the management of type 2 diabetes that could decrease the growing figures of diabetes in the UK.

Reference:

1. www.bddiabetes.co.uk/dyn_en/facts_figures.html
2. www.netdoctor.co.uk/diseases/facts/diabetes.htm
3. Francesco Rubino, MD and Jacques Marescaux, MD, FRCS, Effect of Duodenal–Jejunal Exclusion in a Non-obese Animal Model of Type 2 Diabetes, A new perspective for an old disease, Ann Surg 2004 Jan, 239 (1): 1-11.