Reversal of Diabetes In Sight with a Procedure Similar to Gastric Bypass
Obesity and diabetes are topics that can be found daily in almost any news source. The connection between the two is irrefutable and the relevance and importance of studying the two is undeniable. ECU associate professor and researcher Dr. Tim Gavin has taken on the topic of obesity and diabetes and is taking his research where few have gone.
Gavin, along with the Human Performance Lab, has joined with Drs. John Pender, Lynis Dohm and Walter Pories, to study the implications of the treatment of diabetes by duodenal-jejunal bypass or bypass of the small intestine.
Inspired by the pioneering gastric bypass research by Pories, Gavin began centering his research interest on the mechanisms of diabetes reversal following bariatric surgery.
Beginning in the summer of 2007, Gavin began investigating permanent reversal of diabetes. Obese individuals with diabetes, who lose weight naturally, see a significant reduction in their diabetes symptoms, but once they are weight stable their diabetes tends to return. In gastric bypass surgery, a significant portion of the stomach is bypassed, as is some of the small intestine. Following this bypass, skeletal muscle becomes insulin sensitive and patients often see a rapid reversal in their diabetic symptoms, as well as significant weight loss, on average 100 pounds. Although there is an 80 to 90 percent initial diabetes reversal rate in these bypass patients, the long term reversal of patient’s diabetes is unknown.
Gavin’s diabetes treatment research specifically shows that diabetes is eliminated through the duodenal-jejunal bypass. However, now the research team wants to know if bypassing the duodenum and proximal jejunum without any weight loss or food restriction can successfully reverse diabetes. The team is also hopeful to find if this reversal in diabetes is due to skeletal muscle insulin sensitivity, liver insulin sensitivity, and pancreatic insulin secretion.
Currently, testing is being done on animals, specifically on rats that have poor regulation of blood sugar and a genetic defect that causes constant overeating, which in turn causes obesity. The duodenal-jejunal bypass in these rats show that the muscles become more insulin sensitive, therefore a better job is done in metabolizing the glucose in the blood.
When asked about which procedure would be more beneficial to the patient, gastric bypass or duodenal-jejunal bypass, Gavin was quick to point out that each patient is unique, which makes it is difficult to say which would be more beneficial. He also noted that there are a significant number of diabetic patients who are not obese; therefore gastric bypass would not be an option for them.
Gavin hopes that along with the bypass solution to diabetes, the development of pharmacological agents, in response to understanding the mechanisms of reversal, could potentially be developed for patients.
Initially, Gavin received an internal Research Development Award from the Division of Research and Graduate Studies. He is now in the process of applying for National Institute of Health funding, proposing to conduct studies in humans, but has yet to receive approval or funding.
View the entire October 2008 Issue of Exploration & Discovery
