Posts Tagged ‘ Diabetes ’

Gut feelings about diabetes

March 30, 2012
By Mark Fusco MD

New research has discovered something surprising: a study in mice found that issues with controlling blood sugar–the hallmark of diabetes–may start in the intestines. It has long been theorized that diabetes begins in the liver or pancreas, but researchers at the Washington University School of Medicine in St. Louis found evidence that may upend long-held theories about the disease’s causes. Sugar is stored in the liver and insulin is produced in the pancreas, so scientists have previously looked to those organs for the underlying causes of diabetes. For the study, researchers studied mice that are unable to make fatty acid synthase (FAS) in the intestines, which is a critical enzyme in the production of lipids. FAS is regulated by insulin, and people with diabetes have defects in FAS.
The findings indicated that the mice without the enzyme in the intestines developed chronic inflammation in the gut, a strong predictor of diabetes. They had lost the protective lining of mucus in the intestines that keeps microbes from direct exposure to cells, allowing bacteria to enter cells in the gut. This made the mice sick, and they experienced weight loss and diarrhea. The lead study author, Xiaochao Wei, PhD, explained that in order to keep the mucus layer intact, fatty acid synthase is required. Bad bacteria will invade cells in the colon and the small intestine without this mucus, creating inflammation which contributes to insulin resistance and diabetes. These findings are in agreement with some of the early signs of diabetes, which are often reports of stomach pain and diarrhea. More research is needed; however, FAS, as well as an important component of the intestinal mucosa called Muc2, might be potential targets for diabetes therapy. The researchers will next study diabetic people to see whether FAS is altered in a way similar to the mice.
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Multiple medical societies have recommended Lap-Band weight loss surgery

May 4, 2011
By Mark Fusco MD

Follow this link to see a summary of:

Medical Societies Support of Bariatric Surgery

Prevention Prevails, By Dr. Fusco

January 21, 2011
By Ashley

The wise Benjamin Franklin once stated, “An ounce of prevention is worth a pound of cure.” Since then, this saying or idiom, has been ingrained in our American culture to express that it is better to avoid problems in the first place, rather than try to fix them once they arise.

Last month there were a number of stories in both print and broadcast media about Lap-Band weight loss surgery. The stories reported an FDA (Food and Drug Administration) scientific panel recommended changing the Lap-Band “Directions For Use”. They advised changing the indication for Lap-Band surgery to include lighter patients than previously recommended. Presently weight loss surgery, including Lap-Band, is recommended for patients with a Body Mass Index (BMI) of 40, or 35 and above in patients with weight related illnesses such as diabetes, hypertension, and sleep apnea.

The basis of the FDA panel recommendation came from several studies (both international and US based) in obese patients (BMI between 30 and 35) that showed improved health and successful weight loss after Lap-Band. These studies also showed lower complication rates than typically seen in other weight loss surgeries. Many believe that the positive results of the studies and the favorable recommendation of the FDA scientific panel is a testament to the safety of Lap-Band.

My own observation and belief, as a weight loss surgeon for many years, is that it is a wise decision to confront obesity early-on rather than later. With careful attention to diet, activity and lifestyle, a person can better maintain a healthy weight before obesity has the opportunity to become a huge problem. Unfortunately, at a certain point, nonsurgical treatment has a poor success rate, therefore the safest surgical treatment should be considered earlier rather than later.

As the saying goes… an ounce of prevention is truly worth a pound of cure for a reason.