Bariatric surgery can be effective at putting Type 2 diabetes into remission, and the effects are often seen almost immediately post-surgery, which is long before the patient loses any significant weight. Researchers funded by Diabetes UK at the University of Oxford, together with colleagues in Norway, have identified the role of a key gut hormone called PYY in restoring normal blood glucose levels in people with Type 2 diabetes following bariatric surgery.
During experiments in the laboratory, the team found that bariatric surgery reverts islets (regions of the pancreas that secrete hormones) back into working order. The surgery brought the function of both alpha and beta cells within the islets back to normal: beta cells secrete the hormone insulin and alpha cells secrete the hormone glucagon.
Dr Reshma Ramracheya, lead Diabetes UK researcher based at the University of Oxford, explained, “Research has mostly focused on the importance of beta cells and insulin secretion in Type 2 diabetes, but that’s just part of the story. The fact that alpha cells – and glucagon secretion – are also affected goes some way to completing the equation.”
The team initially considered that a gut hormone called GLP-1 was the driving factor of the beneficial effects of bariatric surgery. However, a different gut hormone, called PYY, was found at higher levels in the blood after the surgery. When they tested this further in the lab using diabetic islets, they found that long-term treatment with PYY could restore the faulty islet function.
These findings may lead to the development of therapies that can put Type 2 diabetes into remission without the need for surgery.
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