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2016
Dec-14
Will the control of Diabetes come from the gut??
By Dr. Tom Babu, MD DNB (Endo)| 0 Comments

Bariatric surgery or weight loss surgery has shown to produce remission (cure as it is falsely referred to often) of diabetes in upto 90 % of obese diabetic individuals undergoing this procedure. The diabetes lowering effect comes from the fact that the food is made to bypass the first portion of the small intestine (duodenum) as seen mainly in the gastric bypass surgery (one form of bariatric surgery). It is a fact that our body absorbs most of its nutrients (carbohydrates, proteins and fats) from the duodenum. It is also seen that the mucosa (the outer layer) of the duodenum is thickened in diabetic patients suggesting that it may be absorbing more nutrients than it is supposed to. Science has come with a new technique called "Duodenal Mucosal Resurfacing" (DMR) wherein a catheter is inserted orally(endoscopically) and the duodenal mucosa thermally ablated (destroyed). This procedure has shown to reduce the blood sugar in diabetic patients reducing the requirement of diabetes treatment. This technique has been tried in a group of 39 diabetic patients with very promising results. I am sure that more studies will follow in this direction and that this procedure will be a novel inclusion in our armamentarium to fight diabetes. 

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