Skip to main content
Top
Published in: Obesity Surgery 5/2016

01-05-2016 | Original Contributions

Is a Simple Food-Diverting Operation the Solution for Type 2 Diabetes Treatment? Experimental Study in a Non-Obese Rat Model

Authors: John Melissas, Drakos Peirasmakis, Vasileios Lamprou, John Papadakis

Published in: Obesity Surgery | Issue 5/2016

Login to get access

Abstract

Background

The feasibility of a side-to-side jejunoileal anastomosis (SJA) to control type 2 diabetes mellitus (T2DM) was studied in non-obese diabetic Goto–Kakizaki (GK) rats.

Methods

Seventeen 14-week-old male GK rats were divided into three groups: SJA bypassing 60 % of the small bowel length, sham-operated jejunoileal bypass (Sham group), and control animals. Rats were observed for 10 weeks after surgery. Fasting blood glucose (FBG) levels and oral glucose tolerance test (OGTT) were measured before and after the procedure.

Results

Animals with SJA exhibited normalization of FBG levels from the 1st and up to the 10th postoperative week when the experiment terminated. OGTT compared with sham-operated and control groups was also significantly better at 3 and 8 weeks postoperatively.

Conclusions

A simple SJA, diverting the food and biliopancreatic secretion to the distal small bowel, was able to normalize both FBG levels and OGTT in a non-obese diabetic rat model.
Literature
1.
go back to reference Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefPubMed Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefPubMed
2.
go back to reference De Sa VC, Ferraz AA, Campos JM, et al. Gastric bypass in the treatment of type 2 diabetes in patients with a BMI of 30 to 35 kg/m2. Obes Surg. 2011;21(3):283–7.CrossRefPubMed De Sa VC, Ferraz AA, Campos JM, et al. Gastric bypass in the treatment of type 2 diabetes in patients with a BMI of 30 to 35 kg/m2. Obes Surg. 2011;21(3):283–7.CrossRefPubMed
3.
go back to reference Scopinaro N, Papadia F, Marinari G, et al. Long-term control of type 2 diabetes mellitus and the other major components of the metabolic syndrome after biliopancreatic diversion in patients with BMI < 35 kg/m2. Obes Surg. 2007;17(2):185–92.CrossRefPubMed Scopinaro N, Papadia F, Marinari G, et al. Long-term control of type 2 diabetes mellitus and the other major components of the metabolic syndrome after biliopancreatic diversion in patients with BMI < 35 kg/m2. Obes Surg. 2007;17(2):185–92.CrossRefPubMed
4.
go back to reference Rubino F, Kaplan LM, Schauer PR, et al. The Diabetes Surgery Summit Consensus conference recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus. Ann Surg. 2010;251(3):399–405.CrossRefPubMed Rubino F, Kaplan LM, Schauer PR, et al. The Diabetes Surgery Summit Consensus conference recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus. Ann Surg. 2010;251(3):399–405.CrossRefPubMed
5.
go back to reference Cohen RV, Schiavon CA, Pinheiro JS, et al. Duodenal-jejunal bypass for the treatment of type 2 diabetes in patients with body mass index of 22–34 kg/m2: a report of 2 cases. Surg Obes Relat Dis. 2007;3(2):195–7.CrossRefPubMed Cohen RV, Schiavon CA, Pinheiro JS, et al. Duodenal-jejunal bypass for the treatment of type 2 diabetes in patients with body mass index of 22–34 kg/m2: a report of 2 cases. Surg Obes Relat Dis. 2007;3(2):195–7.CrossRefPubMed
6.
go back to reference De Paula AL, Stival AR, Halpern A, et al. Improvement in insulin sensitivity and β-cell function following ileal interposition with sleeve gastrectomy in type 2 diabetic patients: potential mechanisms. J Gastrointest Surg. 2011;15(8):1344–53.CrossRefPubMed De Paula AL, Stival AR, Halpern A, et al. Improvement in insulin sensitivity and β-cell function following ileal interposition with sleeve gastrectomy in type 2 diabetic patients: potential mechanisms. J Gastrointest Surg. 2011;15(8):1344–53.CrossRefPubMed
7.
go back to reference Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–10.CrossRefPubMed Santoro S, Castro LC, Velhote MC, et al. Sleeve gastrectomy with transit bipartition: a potent for metabolic syndrome and obesity. Ann Surg. 2012;256(1):104–10.CrossRefPubMed
8.
go back to reference Melissas J, Peppe A, Askoxilakis J, et al. Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic diseases: a promising operation. Obes Surg. 2012;22(7):1104–9.CrossRefPubMed Melissas J, Peppe A, Askoxilakis J, et al. Sleeve gastrectomy plus side-to-side jejunoileal anastomosis for the treatment of morbid obesity and metabolic diseases: a promising operation. Obes Surg. 2012;22(7):1104–9.CrossRefPubMed
9.
go back to reference Dimitriadis E, Daskalakis M, Kampa M, et al. Alterations in gut hormones after laparoscopic sleeve gastrectomy: a prospective clinical and laboratory investigational study. Ann Surg. 2013;257(4):647–54.CrossRefPubMed Dimitriadis E, Daskalakis M, Kampa M, et al. Alterations in gut hormones after laparoscopic sleeve gastrectomy: a prospective clinical and laboratory investigational study. Ann Surg. 2013;257(4):647–54.CrossRefPubMed
10.
go back to reference Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250(2):234–41.CrossRefPubMed Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250(2):234–41.CrossRefPubMed
11.
12.
go back to reference Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.CrossRefPubMed Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.CrossRefPubMed
13.
go back to reference Melissas J, Daskalakis M, Koukouraki S, Dimitriadis E, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18(10):1251–6.CrossRefPubMed Melissas J, Daskalakis M, Koukouraki S, Dimitriadis E, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18(10):1251–6.CrossRefPubMed
14.
go back to reference Melissas J, Leventi A, Klinaki I, et al. Alterations of global gastrointestinal motility after sleeve gastrectomy: a prospective study. Ann Surg. 2013;258(6):976–82.CrossRefPubMed Melissas J, Leventi A, Klinaki I, et al. Alterations of global gastrointestinal motility after sleeve gastrectomy: a prospective study. Ann Surg. 2013;258(6):976–82.CrossRefPubMed
15.
go back to reference Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definite bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.CrossRefPubMed Bohdjalian A, Langer FB, Shakeri-Leidenmühler S, et al. Sleeve gastrectomy as sole and definite bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20(5):535–40.CrossRefPubMed
16.
go back to reference Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology type 2 diabetes. Ann Surg. 2006;244(5):741–9.CrossRefPubMedPubMedCentral Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology type 2 diabetes. Ann Surg. 2006;244(5):741–9.CrossRefPubMedPubMedCentral
17.
go back to reference Mingrone G. Role of the incretin system in the remission of type 2 diabetes following bariatric surgery. Nutr Metab Cardiovasc Dis. 2008;18(8):574–9.CrossRefPubMed Mingrone G. Role of the incretin system in the remission of type 2 diabetes following bariatric surgery. Nutr Metab Cardiovasc Dis. 2008;18(8):574–9.CrossRefPubMed
18.
go back to reference Bikman BT, Zheng D, Pories WJ, et al. Mechanism for improved insulin sensitivity after gastric bypass surgery. J Clin Endocrinol Metab. 2008;93(12):4656–63.CrossRefPubMedPubMedCentral Bikman BT, Zheng D, Pories WJ, et al. Mechanism for improved insulin sensitivity after gastric bypass surgery. J Clin Endocrinol Metab. 2008;93(12):4656–63.CrossRefPubMedPubMedCentral
19.
go back to reference Chambers AP, Jessen L, Ryan KK, et al. Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats. Gastroenterology. 2011;141(3):950–8.CrossRefPubMedPubMedCentral Chambers AP, Jessen L, Ryan KK, et al. Weight-independent changes in blood glucose homeostasis after gastric bypass or vertical sleeve gastrectomy in rats. Gastroenterology. 2011;141(3):950–8.CrossRefPubMedPubMedCentral
20.
go back to reference Amori RE, Lau J, Pittas AG. Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis. JAMA. 2007;298(2):194–206.CrossRefPubMed Amori RE, Lau J, Pittas AG. Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis. JAMA. 2007;298(2):194–206.CrossRefPubMed
21.
go back to reference Sun D, Liu S, Zhang G, et al. Type 2 diabetes control in a nonobese rat model using sleeve gastrectomy with duodenal-jejunal bypass (SGDJB). Obes Surg. 2012;22(12):1865–73.CrossRefPubMed Sun D, Liu S, Zhang G, et al. Type 2 diabetes control in a nonobese rat model using sleeve gastrectomy with duodenal-jejunal bypass (SGDJB). Obes Surg. 2012;22(12):1865–73.CrossRefPubMed
22.
go back to reference Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545–59.CrossRefPubMed Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545–59.CrossRefPubMed
23.
go back to reference Akash MS, Rehman K, Chen S. Goto–Kakizaki rats: its suitability as non-obese diabetic animal model for spontaneous type 2 diabetes mellitus. Curr Diabetes Rev. 2013;9(5):387–96.CrossRefPubMed Akash MS, Rehman K, Chen S. Goto–Kakizaki rats: its suitability as non-obese diabetic animal model for spontaneous type 2 diabetes mellitus. Curr Diabetes Rev. 2013;9(5):387–96.CrossRefPubMed
24.
go back to reference Stein J, Stier C, Raab H, et al. Review article: The nutritional and pharmacological consequences of obesity surgery. Aliment Pharmacol Ther. 2014;40(6):582–609.CrossRefPubMed Stein J, Stier C, Raab H, et al. Review article: The nutritional and pharmacological consequences of obesity surgery. Aliment Pharmacol Ther. 2014;40(6):582–609.CrossRefPubMed
25.
go back to reference Topart P, Becouam G, Salle A, et al. Biliopancreatic diversion requires multiple vitamin and micronutrient adjustments within 2 years of surgery. Surg Obes Relat Dis. 2014;10(5):936–41.CrossRefPubMed Topart P, Becouam G, Salle A, et al. Biliopancreatic diversion requires multiple vitamin and micronutrient adjustments within 2 years of surgery. Surg Obes Relat Dis. 2014;10(5):936–41.CrossRefPubMed
26.
go back to reference Penney NC, Kinross JM, Newton RC, Purkayastha S. The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review. Int J Obes (Lond) 2015 Jun 17 doi: 10.1038/ijo.2015.115 Penney NC, Kinross JM, Newton RC, Purkayastha S. The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review. Int J Obes (Lond) 2015 Jun 17 doi: 10.1038/ijo.2015.115
27.
go back to reference Damms-Machado A, Mitra S, Schollenberger AE, Kramer KM, Meile T, Konigsrainer A et al. Effect of surgical and dietary weight loss therapy for obesity in gut microbiota composition and nutrient absorption. Biomed Res Int 2015:806248 doi: 10.1155/2015/806248 Damms-Machado A, Mitra S, Schollenberger AE, Kramer KM, Meile T, Konigsrainer A et al. Effect of surgical and dietary weight loss therapy for obesity in gut microbiota composition and nutrient absorption. Biomed Res Int 2015:806248 doi: 10.​1155/​2015/​806248
28.
go back to reference Lakhani SV, Shah HN, Alexander K, et al. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass in obese patients. Nutr Res. 2008;28(5):293–8.CrossRefPubMed Lakhani SV, Shah HN, Alexander K, et al. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass in obese patients. Nutr Res. 2008;28(5):293–8.CrossRefPubMed
29.
go back to reference Ishida RK, Faintuch J, Paula AM, et al. Microbial flora of the stomach after gastric bypass for morbid obesity. Obes Surg. 2007;17(6):752–8.CrossRefPubMed Ishida RK, Faintuch J, Paula AM, et al. Microbial flora of the stomach after gastric bypass for morbid obesity. Obes Surg. 2007;17(6):752–8.CrossRefPubMed
Metadata
Title
Is a Simple Food-Diverting Operation the Solution for Type 2 Diabetes Treatment? Experimental Study in a Non-Obese Rat Model
Authors
John Melissas
Drakos Peirasmakis
Vasileios Lamprou
John Papadakis
Publication date
01-05-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1871-8

Other articles of this Issue 5/2016

Obesity Surgery 5/2016 Go to the issue