A US medical ‘dream team’ — led by an Irish scientist — has made a dramatic first step in discovering a cure for Type 2 diabetes.
Breakthrough research at the Cleveland Clinic in Ohio has found that weight loss surgery can dramatically reduce or even eliminate diabetics’ reliance on insulin and other medication.
However, the real achievement may be the discovery of a mystery protein that, if harnessed, could be used to revolutionise future treatment.
Professor John Kirwan (54), from Tullow, Co Carlow, heads up a team of 15 clinical scientists that has been working on the research since 2007.
“It took us a long time. We knew going in that we had something of great clinical significance,” he told the Irish Independent after the findings were published in ‘The New England Journal of Medicine‘.
Type 2 diabetes — also known as adult-onset diabetes — is the most common form of diabetes. It is a chronic disease in which there are high levels of sugar (glucose) in the blood.
The condition is caused by a combination of genetic and lifestyle factors — such as poor diet and obesity — and can lead to long-term complications including heart disease, stroke and kidney failure.
The medical trial at the Cleveland Clinic — conducted by three ‘dream teams’ totalling around 30 scientists — involved 150 patients with obesity and poorly controlled diabetes.
The patients were divided into three groups of 50. One group got intensive medical treatment only, the other two groups received medical treatment and either gastric bypass or sleeve surgery — both of which include operations on the stomach to treat obesity.
Drugs
After 12 months, a far higher proportion of those who underwent the surgical procedures — 42.6pc for gastric and 36.7pc for sleeve — achieved normal blood sugar levels compared with those who had not — 12.2pc.
It proved that weight loss procedures lead to a marked improvement in reducing patients’ reliance on drugs.
“We knew anecdotally that it can work but there were never head-to-head comparisons between surgery and more aggressive medical therapy with drugs that are on the market,” said Prof Kirwan who initially emigrated to the US in 1977.
“Diabetics very often face surgery one way or the other down the road in terms of amputations and loss of limbs. (The question is), is it better to have surgery earlier and for a better quality of life and to avoid medication?
“This is one of the things that has to be considered going forward. Also, how is this actually working? What is it about the surgery that is reducing it (the diabetes)?”
It also needed to be debated if the surgery was appropriate for patients who were not obese, he added.
Prof Kirwan, who has also worked at the renowned Penn State University, said further research was necessary to identify exactly what was behind the success of the surgical trials.
However, he and his team believe it might be a new protein or hormone in the body that is triggered during the operation.
“If we knew what that was we could harness it and turn it on and, in theory, you could reverse the diabetes without surgery,” he said.
– Mark Hilliard
Irish Independent
