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Beta-Cell Sensitivity Increases After Bariatric Surgery

Effect may explain why type 2 diabetes resolves shortly after surgery

THURSDAY, July 20 (HealthDay News) -- Recovery from type 2 diabetes after malabsorptive bariatric surgery is likely due to increased beta-cell sensitivity and because much of food nutrients bypass the hormonally sensitive foregut, according to a report in the July issue of Diabetes.

Geltrude Mingrone, M.D., Ph.D., from Catholic University in Rome, Italy, and colleagues measured insulin sensitivity, secretion, and circulating incretin and adipokine levels in 10 morbidly obese patients before and shortly after biliopancreatic diversion to avoid the confounding effects of weight loss.

The investigators found that insulin sensitivity normalized and diabetes disappeared within one week after surgery. This was accompanied by decreased fasting insulin secretion rates and total insulin output, and by an increase in beta-cell sensitivity.

"Biliopancreatic diversion determines a prompt reversibility of type 2 diabetes by normalizing peripheral insulin sensitivity and enhancing beta-cell sensitivity to glucose, these changes occurring very early after the operation," the authors write. "This operation may affect the enteroinsular axis function by diverting nutrients away from the proximal gastrointestinal tract and by delivering incompletely digested nutrients to the ileum."

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