Type 2 Diabetes – Stomach Surgery and Blood Sugar Levels

Type 2 Diabetes – Stomach Surgery and Blood Sugar Levels – Surgery on the stomach is used for morbid obesity (body mass index higher than 40) that does not respond to a health meal plan and exercise, and has found to be useful for treating Type 2 diabetes; in some cases actually curing the condition. Researchers at Ocean Hospital and Ocean University Hospital in Barcelona, Spain compared two of such stomach procedures with regard to their effect on blood sugar and insulin sensitivity.
Their study, published in the Journal of Gastrointestinal Surgery, March 2012, included fifteen obese diabetics…

7 were treated with a laparoscopic Roux-en-Y gastric bypass (LRYGB), and
8 were given a sleeve gastrectomy (LSG).

The LRYGB causes food leaving the stomach to bypass the duodenum, the beginning of the small intestine. This is accomplished by making a pouch about the size of an egg from part of the stomach, and attaching it to the small intestine below the level of the duodenum. Since the stomach effectively becomes smaller, the diabetic feels full sooner and has less desire to eat. When food bypasses the duodenum, there is less absorption of fats and carbohydrates.
An LSG consists of removal of 75 per cent of the stomach so the person who had the surgery feels full after small meals.
In each group:

blood sugar,
insulin resistance, and
blood insulin levels

were reduced after surgery. The LRYGB diabetics showed significantly lower leptin levels while the LSG group had lower ghrelin levels. Both procedures resulted in increased glucagon-like peptide 1 and peptide YY levels.
Leptin is made and released by fat cells, and tells the brain that there are enough fat stores. Leptin resistance, similar to insulin resistance, causes people to feel hungry even when they have enough leptin.
Ghrelin is the opposite of leptin. It is made in the stomach and pancreas and causes hunger.
Glucagon-like peptide 1, or GLP-1, is secreted by the small intestine in response to receiving food. It acts to increase secretion of insulin and insulin sensitivity and signal the brain that enough food has been received.
Peptide YY is a protein released by the small and large intestines in response to food, and helps to reduce appetite.
Anyone with a body mass index over 40 contemplating surgical procedures should discuss the relative merits of all types with their doctor…

whether lowering leptin in the presence of leptin resistance is necessarily harmful is one question to ask.
another is whether increasing ghrelin is likely to be good for weight loss.

Like all surgery, stomach surgery carries risks which should be carefully weighed against its potential benefits.