While gastric-bypass, or bariatric, surgery can be a very successful weight-loss treatment option for those suffering from obesity, it has also been seen to be extraordinarily effective in reversing type 2 diabetes. An exciting new study from a team at Brigham and Women’s Hospital has now demonstrated an oral agent that can potentially mimic the effects of bariatric surgery to reduce post-meal blood sugar spikes.
For some years, researchers have identified a connection between gastric-bypass surgery and the reversal of type 2 diabetes. The exact mechanism at play is still unclear, but it seems to operate independently of the weight loss that comes as a consequence of the procedure. One recent study comprising 20,000 patients found that gastric bypass surgery completely cured 84 percent of patients with type 2 diabetes.
The new research, at this stage only demonstrated in rats, involves an oral agent that can be swallowed and effectively coat the lining of the small intestine for a short period of time. In rat models it was found that this temporary intestinal barrier alters nutrient contact and lowers blood glucose response following a meal. In animal experiments after the oral agent was administered the average glucose response was reduced by 47 percent, and three hours later the effect disappeared, suggesting the temporary barrier had dissolved.
“What we’ve developed here is essentially, ‘surgery in a pill,’” says Yuhan Lee, co-lead author on the study. “We’ve used a bioengineering approach to formulate a pill that has good adhesion properties and can attach nicely to the gut in a preclinical model. And after a couple of hours, its effects dissipate.”
It is thought that gastric bypass surgery is effective in reversing type 2 diabetes as it improves glucose homeostasis by pushing digestion processes further into the intestine, which can fundamentally alter how the body absorbs nutrients. This new oral stomach-lining compound may effectively mimic this process without the need for major bariatric surgery.
Although the new substance has only been tested on rats so far, the researchers note that the primary compound used has already been approved by the FDA. The basis for the compound is called sucralfate, a drug already regularly used in humans to treat gastrointestinal ulcers.
As well as offering a potential breakthrough treatment for type 2 diabetes, the research could point to an entirely new drug delivery method that would allow for targeted delivery of substances to different points in the gastrointestinal tract.