Clinical Gastroenterology Vol.28 No.6(12)

Theme The Roles of Gut Physiological Active Peptides in the Control of Nutrition and Metabolism
Title Duodeno-jejunal Bypass for Type 2 Diabetes
Publish Date 2013/06
Author Susumu Aiko Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo
Author Yasuyuki Seto Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo
[ Summary ] The concept of "metabolic surgery" for type 2 diabetes patients has recently been highlighted because of the great number of reports concerning bariatric surgery for morbidly obese individuals. Bariatric surgery can dramatically resolve type 2 diabetes, often before weight loss occurs and out of proportion to postoperative weight loss. The hindgut hypothesis and the foregut hypothesis are thought to explain mechanisms related to improvments in diabetes. The secretion of gastrointestinal hormones such as glucagon-like peptide (GLP)-1 due to changes in the gastrointestinal tract route is considered to play an animportant role in this process. Duodemo-jejunal bypass procedures are performed as types of metabolic surgery. Basic research, using rats models, is underway to reveal this mechanism. On the other hand, clinical trials have already been carried out in some countries. Duodemo-jejunal bypass procedures have been shown to be effective in treating type 2 diabetes in both overweight and mildly obese subjects.
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