Now some researchers at the University of Maryland believe their work may explain why the surgery succeeds, and how a common drug may be used to induce similar effects.
The researchers plan to begin studies with humans this fall, though a pill to cure diabetes may be a long way off, said Steven D. Munger, a professor of anatomy and neurobiology in Maryland School of Medicine who has been working with other researchers on animals models for more than two years.
“If we could find a way of mimicking the anti-diabetes surgery without surgery, it might be a nice alternative and whole new way of therapeutically addressing diabetes,” said Munger, whose research recently was published in the American Journal of Physiology – Endocrinology and Metabolism.
“Everyone might not be a candidate or want surgery,” he said.
Almost 26 million Americans now have diabetes, most with Type 2, in which the body doesn’t produce enough or doesn’t process insulin needed to convert sugar and starches to energy, according to the American Diabetes Association. This form of the disease is linked to excessive weight, putting another 79 million in the pre-diabetic category.
Diabetes sufferers have higher rates of heart disease and stroke, high blood pressure, blindness, kidney and nervous system disorders and amputations. The disease is estimated to cost the nation $116 billion a year in direct medical costs.
The diabetes association stops short of recommending surgery but says it should be considered for obese people who have other health problems not controlled with medications and lifestyle changes. The surgery, the group said, carries risks and still requires patients to adhere to significant dietary changes and life-long monitoring.
The type of surgery that seems to work is gastric bypass, which shrinks the stomach considerably and shortens the rest of the digestive system. Studies show the surgery cures diabetes in about 78 percent of patients, usually before weight loss occurs.
No one has been sure why, but a hormone called glucagon-like peptide-1, or GLP-1, has been suspected to play a role for about a decade.
In a person without diabetes, the stomach uses the hormone to warn the pancreas to make insulin when there is an increase in sugar in the blood.
People with Type 2 diabetes have a defect in how the body responds to and produces insulin in the pancreas. Increasing GLP-1 levels can help increase insulin production to levels where it can control blood sugar, and gastric bypass seems to increase GLP-1 production.
