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Diabetes is Now a Disorder of the Small Intestine?

Posted By Mark Sisson On March 7, 2008 @ 1:07 pm In Big Pharma,Health | 34 Comments

I’m not a doctor… and I don’t play one on TV, but fer cryin’ out loud, when will they learn? I just want to SCREAM sometimes. Seems bariatric surgery as a possible cure for type 2 diabetes was not enough. Old technology. Now the rocket scientists have determined that surgically bypassing the upper part of the small intestine can cure type 2 diabetes even better than that silly old gastric bypass weight-loss “breakthrough” of just a few months ago. Read this Science Daily [7] article and tell me I didn’t eat bad mushrooms in my salad today.

‘When we bypass the duodenum and jejunum, we are bypassing what may be the source of the problem,’ says Dr. Rubino, who is heading up NewYork-Presbyterian/Weill Cornell’s Diabetes Surgery Center.

In fact, it has become increasingly evident that the gastrointestinal tract plays an important role in energy regulation, and that many gut hormones are involved in the regulation of sugar metabolism. ‘It should not surprise anyone that surgically altering the bowel’s anatomy affects the mechanisms that regulate blood sugar levels, eventually influencing diabetes,’ Dr. Rubino says.

Surgically altering the bowel’s anatomy? People, the source of the problem is bad diet and lack of exercise. Full stop. I’ve said it a hundred times here. Give me 95% of type 2s and I can cure them of diabetes forever in 90 days if they simply eat and exercise right. It’s not easy, but it’s free and doesn’t leave you messed up for life. Life is all about gene expression. Send the wrong signals and your genes express themselves in the direction of diabetes. Send the right signals and you’ll decrease insulin, increase muscle cell insulin sensitivity and normalize blood glucose, burn fat and preserve muscle. And all the recent discussion [8] here on MDA about “all the many genetic differences we are seeing in the human population” doesn’t change a thing. The fact that some of us are predisposed to respond to dietary changes slightly faster or slower than others doesn’t remove the fact that our basic biochemistry all works the same. Yes, that same way we were designed by evolution. Yet, Dr. Rubino is suggesting that this miracle surgery might be the only hope for millions of us.

In fact, bypass of the upper small intestine does not improve the ability of the body to regulate blood sugar levels.

[but didn't he just imply otherwise?]

‘When performed in subjects who are not diabetic, the bypass of the upper intestine may even impair the mechanisms that regulate blood levels of glucose,’ says Dr. Rubino. ‘In striking contrast, when nutrients’ passage is diverted from the upper intestine of diabetic patients, diabetes resolves.’

So what does that mean for a new surgically-corrected diabetic patient who finally decides to eat and exercise correctly? I guess he or she is just hosed for life? You gonna reconnect the bowel now? So much for homeostasis. And here’s the kicker:

There is, in fact, growing evidence that diabetes surgery can be effective even for patients who are only slightly obese or just overweight.

Leave it to a surgical specialist to come up with a plumbing cure for type 2 diabetes that applies to all 20 million in the US alone. Even at only $30,000 per procedure, let’s see, that’s six hundred billion dollars worth of business. Nice work if you can get it.

This, he explains, implies that the upper intestine of diabetic patients may be the site where an abnormal signal is produced, causing, or at least favoring, the development of the disease.

How exactly the upper intestine is dysfunctional remains to be seen. Dr. Rubino proposes an original explanation known in the scientific community as the ‘anti-incretin theory.’

By the way, I Googled “anti-incretin theory” and got four results, all as uttered by Rubino, so it’s unclear how the rest of the scientific community actually even feels about this theory.

I could dissect the rest of the article – everything said in it makes me want to puke. I know the good doctor is a well-respected specialist, but that just makes it even worse. I’m sure there’s a bunch of surgeons already drinking the Kool-aid and girding (maybe GERDing) their loins for a new rush in business. I can just feel my cortisol levels rising as I write this. Maybe the good doc can find a way to surgically bypass my adrenals. Just reroute the plumbing, doc. After all, stress is bad, and lord knows there’s no other possible way for me to avoid stress in my life. Am I just another hapless victim of bad genes?

Speak to me.

harrymoon [9] Flickr Photo (CC)

Further Reading:

Lap Bands and Type 2 Diabetes [10]

The Definitive Guide to Insulin, Blood Sugar and Type 2 Diabetes (and you’ll understand it) [11]

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