This is a potential Game Changer:


http://www.medscape.com/viewarticle/764745?src=mpnews&spon=34
Curing Diabetes Via Surgery, Without Weight Loss　

"Curiously, although patients shed pounds, there was no correlation between weight loss and blood glucose. "Bariatric surgery is more effective on diabetes than obesity," said Dr. Rubino. "Patients don't become lean, but they do not have diabetes anymore."

Research from the University of Toronto, reported online this month in Nature Medicine, may finally explain why. It examined the effects of bypass surgery on rats with type-1 diabetes, which is considered even harder to treat than type-2.

Normally the jejunum receives only digested mush, as nutrients have already been absorbed in the duodenum, explained lead researcher Tony Lam. Bypassing the duodenum allows the jejunum to receive an influx of nutrients for the first time, said Lam. Sensing them, the jejunum sends a "got glucose!" signal to the brain. The brain interprets that as a sign of glucose overabundance and orders the liver to decrease glucose production. Result: The rats no longer have diabetes.

"I believe that similar mechanisms are taking place in surgery for type-2 diabetes," said Lam. "It strengthens the case for the surgery treating diabetes independent of weight loss."

His rat study shows why lap banding and stomach stapling are less effective against diabetes than gastric bypass. Banding causes diabetes to go into remission in about 50% of patients, probably due to weight loss, said endocrinologist Dr. Allison Goldfine of the Joslin Diabetes Center in Boston.

In contrast, the diabetes-remission rate after Roux-en-Y is 80% to 85%. "The improvements in blood glucose with Roux-en-Y appear to occur very early, by day three after surgery, so patients are being discharged with no medication," she said. Something other than weight loss "must be going on."