How Does Gastric Bypass Surgery Cure Type 2 Diabetes?

Doctors aim to ‘bypass the bypass’ by helping the small intestines of diabetes patients get rid of excess glucose.

Gastric bypass surgery often improves the symptoms of type 2 diabetes, even before patients start to lose weight. Why?

“What we found is that the secret for the cure of diabetes after gastric bypass lies in the intestine,” said Dr. Nicholas Stylopoulos, principal investigator at the Division of Endocrinology at Children’s Hospital Boston and Boston Medical School, in an interview with Healthline. “The key message is that after gastric bypass the intestine becomes the most important tissue for glucose use and this decreases blood sugar levels.”

His research was published last week in the journal Science.

Doctors are hopeful they can find a way to mimic the processes that lead to improvements for type 2 diabetics after gastric bypass without actually doing the surgery.

Small Intestine to the Rescue

Here’s how it works: After gastric bypass, which is a common weight loss solution for the severely obese, the small intestine spontaneously begins to produce a molecule called GLUT-1 that helps the body use glucose.

“The quite amazing thing is that this is not present normally in the small intestine of adults, but only in the fetus,” said Dr. Erini Nestoridi, a research fellow in Stylopoulos’ lab, in an interview with Healthline. “This happens most likely because the intestine has to work harder to do its job, for example to absorb the nutrients or move the food further down. Also, it may be that the mechanical stress of ‘dumping’ the food directly to the intestine, since the stomach is bypassed, contributes to these changes.”

Although weight loss and improved diabetes symptoms go hand in hand, previous research has shown that gastric bypass surgery helps resolve the disease even before weight loss occurs.

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