Is a Simple Food-Diverting Operation the Solution for Type 2 Diabetes Treatment? Experimental Study in a Non-Obese Rat Model

Melissas, John; Peirasmakis, Drakos; Lamprou, Vasileios; Papadakis, John A.

doi:10.1007/s11695-015-1871-8

Cited by 6 publications

(5 citation statements)

References 29 publications

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“…Others have reported improved glucose metabolism following PID in animal models and clinical studies involving patients. 6,7,15,16 It is clear that in the case of PPID, we observed a significant (and comparable to VSG) improvement in glucose tolerance despite a non-significant reduction in body fat. VSG and DPID improve glucose tolerance and cause profound reductions in body fat.…”

Section: Pid Results In Notable Improvement In Glucose Metabolismsupporting

confidence: 63%

“…15,16 Body weight and fat mass loss relative to Sham has also been reported in animals. 7,15 Though notable improvements in glucose metabolism are observed after DJB, body weight and composition outcomes relative to Sham are not altered by this procedure. 19,25,26 These data support our findings that a duodenal component to the PID may render this operation less effective for weight loss.…”

Section: Dpid Induces Lower Body Weight and Fat Mass Relative To Sham And It Is Superior To Ppidmentioning

confidence: 93%

“…The impact of PID on body weight has been described by a handful of reports. 6,7,15,16 One study of 10 patients with mean preoperative body mass index (BMI) of 41.1 kg/m 2 reported 14.6% of total body weight loss (%TBWL) at 12 months. 6 Others studied this operation in patients with mean BMI of 31.2 and 34.1 kg/m 2 and described a %TBWL at 12 months of 11.4 and 10.5 correspondingly.…”

Section: Dpid Induces Lower Body Weight and Fat Mass Relative To Sham And It Is Superior To Ppidmentioning

confidence: 99%

“…This operation has also been referred to as partial jejunal diversion and side-to-side jejunoileal anastomosis. 6,7 The procedure is performed by creating a single side-to-side enteroenterostomy partially excluding a loop of small intestine from the flow of chyme (Figure 1). Given the relative technical ease and potentially low complications associated with constructing a single enteroenterostomy, if effective, the PID could expand the surgical choices available for the treatment of obesity and related comorbidities.…”

Section: Introductionmentioning

confidence: 99%

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A rodent model of partial intestinal diversion: a novel metabolic operation

Alvárez

Sandoval

Seeley

2020

Surgery for Obesity and Related Diseases

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Background-Metabolic surgery is safe and the most effective therapy for obesity and its comorbidities. New procedures may allow for better tailoring of metabolic surgery to the individual patient.Objective-To evaluate the impact, comparative effectiveness, and mechanisms of the partial intestinal diversion (PID), vertical sleeve gastrectomy (VSG), and the combination of PID and VSG on body weight and glucose regulation.Setting-University research facility, United States.Methods-Three cohorts of high-fat diet-induced obese male rats were randomized to distal partial intestinal diversion (DPID), proximal partial intestinal diversion (PPID), vertical sleeve gastrectomy (VSG), VSG and DPID (VSG/DPID), or sham operation (Sham). Animals were followed for 11 (cohort 1) or 10 (cohorts 2 and 3) weeks. Outcomes included body weight and composition, food intake, glucose metabolism, lipids, bile acids, and energy balance. Statistical comparisons were performed using Tukey's multiple comparison test applied to ANOVA.Results-DPID and not PPID resulted in significant weight and body fat reductions relative to Sham. Improved glucose tolerance was seen in all surgical groups though this reached statistical significance for only DPID and VSG when compared with Sham. Improvements in baseline glucose and insulin, corresponding insulin resistance, and plasma lipids were noted in DPID compared to Sham. Though the magnitude of weight and body composition changes and metabolic benefit tended to be larger for VSG relative to DPID, it only reached statistical significance for lipids. VSG and VSG/DPID resulted in similar outcomes. Markedly reduced food intake occurred after VSG and more modestly after DPID. Stool caloric content was higher in DPID relative to all groups.Conclusions-DPID is an effective metabolic operation resulting in notable weight and fat loss and metabolic improvement relative to sham-operated rodents. Interestingly, combining VSG with DPID added little additional benefit to the effects of VSG.

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Section: Pid Results In Notable Improvement In Glucose Metabolismsupporting

confidence: 63%

Section: Dpid Induces Lower Body Weight and Fat Mass Relative To Sham And It Is Superior To Ppidmentioning

confidence: 93%

Section: Dpid Induces Lower Body Weight and Fat Mass Relative To Sham And It Is Superior To Ppidmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A rodent model of partial intestinal diversion: a novel metabolic operation

Alvárez

Sandoval

Seeley

2020

Surgery for Obesity and Related Diseases

View full text Add to dashboard Cite

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“…In contrast, PSIB did not transect the jejunum, but only made a simple side-to-side anastomosis of the small bowel, which maintained the normal electrophysiology of the small bowel, enabling a certain amount of paraproperistalsis in the bypassed small bowel segments, with a much smaller amount of food regurgitation than that of the end-to-side anastomosis of JIB. Melissas et al [10] reported that simple side-to-side jejunoileal anastomosis (SJA) to transfer food and biliopancreatic secretions to the distal small bowel normalized FBG levels and OGTT in Goto Kakizaki rats. Therefore, we hypothesized that one of the reasons for the superior e cacy of PSIB over JIB in lowering blood glucose levels could be attributed to the side-to-side anastomosis, which eliminates the retrograde peristalsis of the bypassed small bowel segment, thereby reducing glucose absorption [11].…”

Section: Discussionmentioning

confidence: 99%

Proximal Small Intestine Bypass Outperforms Roux-en-Y and Jejunoileal Bypass in Glucose Regulation in Streptozotocin‑Induced Diabetic Rats

Xu,

Tan,

Luo

et al. 2024

Preprint

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Background This study aimed to compare the efficacy of modified proximal small intestine bypass (PSIB), Roux-en-Y gastric bypass (RYGB), and conventional jejunoileal bypass (JIB) in weight loss and glucose metabolism in streptozotocin (STZ)-induced diabetic rats. Methods Rats with STZ-induced diabetes were randomly divided into PSIB, RYGB, JIB, and sham-operated (sham) groups. Body weight, food intake, fasting blood glucose (FBG) level, oral glucose tolerance test (OGTT), insulin tolerance test (ITT), liver function, and blood lipids were measured in rats in each group from 1 to 6 weeks after surgery. Results No significant difference in the body weight of the rats in the PSIB and RYGB groups was observed postoperatively, whereas the body weight of the rats in the JIB group was significantly lower. The food intake of the rats in all three surgical groups was significantly less than that in the sham group. The PSIB group had a better glucose-lowering effect than the RYGB and JIB groups. Glucose tolerance improved significantly in all three surgical groups at 2 weeks postoperatively; with improved glucose tolerance in the PSIB group than in the RYGB and JIB groups. At postoperative week 2, insulin sensitivity improved only in the PSIB group; however, by postoperative week 6, insulin sensitivity improved significantly in both the PSIB and JIB groups. Conclusion PSIB demonstrated excellent hypoglycemic effects and OGTT improvements in the early postoperative period, with better efficacy than that of RYGB and JIB. Compared with PSIB and RYGB, conventional JIB was more effective for weight loss.

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A Simple Food-Diverting Operation for Type 2 Diabetes Treatment. Preliminary Results in Humans with BMI 28–32 kg/m2

et al. 2016

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A simple SJA, diverting the food and biliopancreatic secretion to the distal small bowel, was able to control T2DM in all patients offering total or partial remission of the disease soon after the procedure. Those preliminary data and the simplicity of the operation are encouraging and promising. However, further studies are in progress in both Institutions to reveal the possible mechanism of diabetes control and investigate the effect of this operation on larger number of patients, with longer follow-up period.

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Is a Simple Food-Diverting Operation the Solution for Type 2 Diabetes Treatment? Experimental Study in a Non-Obese Rat Model

Abstract: A simple SJA, diverting the food and biliopancreatic secretion to the distal small bowel, was able to normalize both FBG levels and OGTT in a non-obese diabetic rat model.

Cited by 6 publications

References 29 publications

A rodent model of partial intestinal diversion: a novel metabolic operation

A rodent model of partial intestinal diversion: a novel metabolic operation

Proximal Small Intestine Bypass Outperforms Roux-en-Y and Jejunoileal Bypass in Glucose Regulation in Streptozotocin‑Induced Diabetic Rats

A Simple Food-Diverting Operation for Type 2 Diabetes Treatment. Preliminary Results in Humans with BMI 28–32 kg/m2

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