Often Type 2 diabetes is related to excess weight in the belly. Researchers recognized that obese individuals with Type 2 diabetes who had their stomach size restricted (i.e. gastric banding) also had an improvement of their diabetes.

Francesco Rubino, MD, New York Presbyterian Hospital, Weill Cornell Medical Center, decided to see what effect gastrointestinal bypass operations (i.e. gastric bypass) would cause a remission of diabetes even if performed when the subject was not obese.

Rubino found that the gastrointestinal tract plays an important role in energy regulation; that many gut hormones are involved in the regulation of sugar metabolism. By surgically altering the bowel’s anatomy with a gastric bypass, in both obese and non-obese subjects, he found that the blood sugar levels were affected in all subjects.

Specifically, when the duodenum and jejunum are bypassed during gastric bypass surgery the blood sugar levels appear to be affected. Rubino suspects that when gastric bypass was performed on the animal subjects–who were not diabetic– blood levels of glucose was disrupted. It is possible that the same disruption in diabetic subjects improves diabetes when nutrients’ are diverted from the upper intestine.

Type 2 diabetes accounts for 90-95% of all diabetes cases, which afflicts more than 200 million people worldwide. Gastrointestinal surgery is a major shift in the way diabetes treatment can be considered.