Bariatric Technique Increases Insulin Sensitivity

A study of two techniques used in weight-loss surgery shows that billopancreatic diversion can double insulin sensitivity in patients, compared to gastric bypass surgery.

Excessively overweight patients can have many medical problems, including insulin resistance and often type 2 diabetes. Bariatric surgery for such patients leads to weight loss and improves insulin sensitivity. In the study, 18 nondiabetic patients with severe obesity and 20 lean subjects underwent metabolic studies, including the measurement of insulin activity. The obese patients then underwent either gastric bypass, which restricts food intake by making the stomach very small, or billopancreatic diversion, which shortens the small intestine and reduces fat absorption. Patients were followed at five to six months and again at 16-24 months after surgery.

"In the present study, the physiological difference between gastric bypass and billopancreatic diversion was exploited to highlight the link between lipid malabsorption and insulin action,” explained Alza Muscelli, M.D., of the State University of Campinas (Sao Paulo, Brazil). "However, the choice of the optimal therapeutic strategy in these patients depends on a risk/benefit algorithm to be assessed in each patient.”

The study was published in the January 2005 issue of The American Journal of Medicine. Other researchers from the Catholic University in Rome (Italy) and the University of Pisa (Italy) also participated in the study.




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