Open AccessThe Mechanism of Diabetes Control After Gastrointestinal Bypass Surgery Reveals a Role of the Proximal Small Intestine in the Pathophysiology of Type 2 Diabetes
Author(s) -
Francesco Rubino,
Antonello Forgione,
David Cummings,
Michel Vix,
Donatella Gnuli,
Geltrude Mingrone,
Marco Castagneto,
Jacques Marescaux
Publication year - 2006
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/01.sla.0000224726.61448.1b
Subject(s) - medicine , small intestine , diabetes mellitus , stomach , glucose homeostasis , type 2 diabetes , endocrinology , pathophysiology , weight loss , homeostasis , duodenum , gastroenterology , insulin resistance , obesity
Most patients who undergo Roux-en-Y gastric bypass (RYGB) experience rapid resolution of type 2 diabetes. Prior studies indicate that this results from more than gastric restriction and weight loss, implicating the rearranged intestine as a primary mediator. It is unclear, however, if diabetes improves because of enhanced delivery of nutrients to the distal intestine and increased secretion of hindgut signals that improve glucose homeostasis, or because of altered signals from the excluded segment of proximal intestine. We sought to distinguish between these two mechanisms.