Weight loss as a cure for Type 2 diabetes: fact or fantasy?

Abstract

Evaluation of: Hofso D, Jenssen T, Bollerslev J et al. β cell function after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention. Eur. J. Endocrinol. 164, 231–238 (2011).

Although individuals with obesity and Type 2 diabetes are insulin resistant, pancreatic β-cell failure is the core defect that distinguishes individuals who eventually develop diabetes. This process is known to occur well before the onset of hyperglycemia. Although clinical trial data support the effectiveness of intensive lifestyle modification in delaying the onset of diabetes in obese subjects, less is known about the effects of, and mechanisms underlying, bariatric surgery, particularly gastric bypass surgery, on diabetes. The paper under evaluation clarifies the role of both lifestyle intervention and gastric bypass surgery on pancreatic β-cell function and raises questions regarding the role of weight loss versus incretin-related mechanisms on recovery of β-cell failure.

Keywords::

• β-cell function
• gastric bypass surgery
• insulin resistance
• lifestyle modification
• obesity
• Type 2 diabetes
• weight loss

Financial & competing interests disclosure

Sangeeta R Kashyap and John P Kirwan receive grant support from the National Institutes of Health (grant numbers RO1 DK089547-01 and RO1 AG12834-10) and the American Diabetes Association. Emily S Louis was supported by NIH training grant T32DK007319. Sangeeta R Kashyap also receives research funding from Ethicon Endo-Surgery Inc., and John P Kirwan receives research funding from Nestlé. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.