Most people with type 2 diabetes who undergo bariatric surgery find their glucose metabolism returns to normal within days or weeks of the surgery. But researchers have been uncertain as to why. This study (101-OR) explores the idea that it has to do with where the food comes into contact with the intestines. It found that bypassing the upper part of the small intestine and the stomach (sending it straight to the lower small intestine) helps improve glycemic control, regardless of weight loss.

A separate study (102-OR) used continuous glucose monitoring to compare glucose variations in patients who underwent two different types of weight loss surgery (gastric bypass and biliopancreatic diversion with duodenal switch). It found high rates of hypoglycemia in both groups, which had frequently gone unnoticed. However, variations in glucose levels differed among the groups: Those who underwent gastric bypass surgery experienced larger variations in glucose levels throughout the day but mean levels were normal, while the biliopancreatic group experienced fewer variations throughout the day and normal means. The authors recommend that more attention be paid to hypoglycemia in patients who undergo this type of surgery.

Finally, a retrospective study (98-OR) found that obese patients who underwent weight-loss surgery in Italy, in the form of gastric banding, had dramatically reduced mortality rates and were less likely to develop heart disease and type 2 diabetes than those who received standard medical treatment.

There has long been interest in the potential for an inhaled insulin product but none has yet to commercially succeed. Previous products have raised issues with impaired pulmonary function. Two studies, required for FDA approval of the product, look at the efficacy and safety of an inhaled insulin product currently under review by the FDA. One (127-OR) found that the inhaled product resulted in less hypoglycemia and less weight gain, with no difference in pulmonary function, than injected insulin.

In another study (128-OR), patients with uncontrolled type 2 diabetes who had never been treated with insulin took either inhaled insulin or an inhaled placebo and saw greater improved blood glucose control with minimal weight gain using the inhaled insulin. Overall frequency of hypoglycemia, though greater with the inhaled insulin product, was relatively low. The FDA is expected to issue a decision in July.

From ADA, Nyhetsinfo

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