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Isolation of Human Islets from Partially Pancreatectomized Patients

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Type 2 diabetes mellitus: a possible surgically reversible intestinal dysfunction.

Priscila C Sala¹, Raquel S Torrinhas, Steven B Heymsfield

¹Department of Gastroenterology, Digestive Surgery Discipline, LIM 35, University of São Paulo, Medical School, Av Dr Arnaldo, 455 Cerqueira César, CEP 01246-930 São Paulo, Brazil. priscila_csala@hotmail.com

Obesity Surgery

|November 19, 2011

Summary

Bariatric surgery, particularly with intestinal bypass, effectively treats obesity and achieves early remission of type 2 diabetes mellitus (T2DM). This review explores mechanisms like altered gut signals and insulin sensitivity, aiding T2DM treatment research.

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Area of Science:

Metabolic Surgery
Endocrinology
Gastroenterology

Background:

Type 2 diabetes mellitus (T2DM) is a significant global health issue, frequently linked to obesity.
Bariatric surgery offers an effective solution for severe obesity and demonstrates remarkable metabolic benefits.
Intestinal bypass techniques within bariatric surgery are particularly noted for inducing complete and early T2DM remission.

Purpose of the Study:

To review and elucidate the potential mechanisms behind the rapid normalization of glycemic homeostasis post-bariatric surgery.
To consolidate current hypotheses regarding how intestinal bypass influences glucose metabolism and insulin sensitivity.
To identify areas for future research in T2DM treatment and pharmaceutical target discovery.

Main Methods:

Literature review of existing studies on bariatric surgery and T2DM.
Analysis of proposed physiological and hormonal pathways involved in glycemic control.
Synthesis of evidence regarding changes in intestinal function and insulin sensitivity.

Main Results:

Bariatric surgery promotes early T2DM remission through mechanisms including intestinal gluconeogenesis.
Increased secretion of antidiabetogenic signals from distal L cells is a key factor.
Impaired secretion of diabetogenic signals from the upper small intestine also contributes to improved glycemic control.
Alterations in unknown factors regulating insulin sensitivity are implicated.

Conclusions:

Bariatric surgery, especially with intestinal bypass, offers significant metabolic advantages for T2DM management.
Understanding these mechanisms is crucial for developing novel, less invasive T2DM treatments.
Further research may uncover new pharmaceutical targets for enhancing glycemic control.