Gastric surgery could REVERSE diabetes by improving the body’s response to insulin

A GASTRIC bypass can reverse diabetes by boosting good gut bacteria and metabolism and improving sensitivity to insulin.

Previous research has shown bariatric surgery can lead to remission in Type 2 diabetes — which affects nine in ten British diabetics.

The new study found bypass surgery improves glucose tolerance and insulin sensitivity and experts said it improved metabolism by changing gut microorganisms.

Scientists examined duodenum-jejunum gastric bypasses, commonly called an EndoBarrier, which suggested to scientists that changing gut bacteria plays a role in diabetes remission.

This surgery involves fitting a bypass from the first portion of the small intestine from the stomach to the secondary stage of the small intestine to limit the interaction of food with enzymes and hormones in the intestine.

Dr Xiang Gao of Nanjing University said: "Our research showed that duodenum-jejunum gastric bypass (DJB) surgery may be applied to cure diabetes of both genetic (mutation) and environmental (diet-induced) origin.

"We found that DJB surgery induced gut microbiota alterations, which may be the key reason for diabetes remission after bariatric surgery.

"Our data indicate that suppressed inflammation is the result, not the cause, of diabetes reversal in these genetically modified mice."

The study involved mice withy type 2 diabetes that mimics key symptoms including insulin resistance, high blood levels of lipids, metabolic inflammation, and obesity.

Dr Gao added: "Our findings suggest that Bdnf [a brain protein] deficiency-induced diabetes can be reversed by DJB surgery in mice, which has potential for the treatment of diabetes in humans."

The bypass surgery reversed the metabolic abnormalities indicative of diabetes without changing Bdnf expression directly.

The scientists found glucose tolerance and insulin sensitivity were greatly improved and there was less fat accumulation in liver and white adipose tissue.

Insulin sensitivity reached normal levels within two weeks following surgery and lasted for at least eight weeks.

Six weeks after bypass surgery, oral glucose tolerance in the treated mice was significantly lower than in the diabetic mice that had not had the operation. 

When researchers examined the composition of bacteria and other microorganisms in the gut of mutated mice before and after bypass surgery.

Dr Gao said: "More mechanistic studies of gut microbiota alterations after bypass surgery are needed to explain how different families of microbiota may regulate nutrient metabolism in the host."

He added inflammation, especially in white fat tissue and liver, is thought to play an important role in obesity and type 2.

Eight weeks after bypass surgery, significant reductions in inflammatory indicators occurred in the liver and fat tissue, although the post-surgical anti-inflammatory effects occurred after insulin sensitivity improved. 

He said: "These results indicate that the alleviation of inflammation was not the direct cause of the improvement in insulin sensitivity that resulted from bypass surgery."

The study was published in The American Journal of Pathology.

This comes after it was revealed Obese patients can now swallow a gastric balloon instead of having surgery to lose weight.