Le diabète, la recherche et l'accompagnement.
Diabetes, Research and Support
Quoi de neuf en recherche!
Voici un communiqué de presse du Centre Hospitalier Régional Univeritaire de Lille.
andrepositif vous apporte les plus ressante nouvelles mondiale sur le diabète.
Improve diabetes by separating the sugar from the salt: the Surgery to dietetics.
Unit researchers Joint Research 1190 "Translational Research
on Diabetes "(University of Lille - INSERM - University Hospital of Lille) directed
by Prof. Pattou, just explain the physiological mechanism by which
surgery for obesity called "bypass" gastric improves diabetes
Type 2. From a more general perspective, their discovery suggests that
simple dietary measures mimicking the effect of the surgery, as the decrease
the simultaneous ingestion of salt and sugar, may help prevent
diabetes. This work is published in the journal Cell Metabolism (*).
Since its recommendation by the National Health Authority in 2009,
Bariatric surgery has been performed in more than 200 French, 000 with obesity
severe. Also in patients with type 2 diabetes, the bypass
of the stomach, called gastric bypass (see Fig.1 for diagram of the intervention)
also results in a rapid decrease of blood sugar in the blood (blood sugar). A
After surgery, many patients can reduce or even stop their medication
antidiabetics, before losing weight.
The mechanisms of this spectacular effect of surgery on diabetes remain
mysterious. Their understanding is however essential. Beyond the surgery,
elucidating the links between the gut, diet and glycemic control
could open new perspectives for the treatment of diabetes
type 2, a disease that affects 5% of French and more than 300 million people
in the world. This subject is therefore the object from an intense decade
research worldwide. Several complex mechanisms have been suggested,
involving the role of blood or nervous signals induced by surgery and
modulating insulin secretion or utilization of sugar by target tissues.
None of these studies, carried out mostly in rodents, however, allows
to satisfactorily explain all the results observed in humans.
On the website of the Lille Hospital and University campus, the Mixed Unit
Search 1190 "Translational research on Diabetes" led by
Pr François Pattou (University of Lille - INSERM - University Hospital of Lille), a team
LABEX European Genomic Institute for Diabetes (Egid) with teams
Lille University Hospital of the Medical have addressed the issue. With the availability
voluntary patients, the researchers first found that gastric bypass
limited absorption of ingested sugars, and therefore the elevation of blood glucose
after lunch. To explain these findings, they then studied the consequences
the operation in the minipig, an omnivorous mammal, whose anatomy
and digestive physiology are very similar to those of humans. On February 25, they
reported in an article published in the journal Cell Metabolism (*) Results
The Lille Researchers have identified a simple mechanism:
after a gastric bypass, the ingested sugar is no longer absorbed in the portion
low intestine, when in contact with the bile. In addition, this effect of the
Bile is canceled in the presence of phlorizin, an inhibitor of glucose uptake,
naturally contained in the apple peel. Finally, the addition of sodium (salt)
the meal was enough for researchers to restore the absorption of sugar in the part
high of the intestine, and increase the postprandial glucose levels in animals
operated. Enjoying the particular anatomical context of the gastric bypass, researchers
and emphasize the essential influence of sodium on the intestinal absorption
glucose. They also demonstrated that it is the endogenous sodium excreted in the
bile and digestive secretions, which provides the majority of the physiological absorption
glucose from the intestine.
Selective reduction of the absorption of glucose from the intestine,
is not no doubt not the only explanation spectacular results Bypass
gastric. Thus, weight loss and decreased appetite for food
Sweet also seem to play an important role in maintaining the long-term
results. The hypothesis of Lille researchers however reconciles theory and
clinic, explaining several observations previously misunderstood, as the decrease
Instant sugar levels after a meal in patients with diabetes
operated, or the efficiency of interventions reducing the length more
More generally, these results confirm the influence of the content
salt meals on the rise in blood sugar, recently illustrated in individuals
healthy, by an Israeli study (Zeevi et al. Cell 2015). The researchers Lille
Moreover conclude their work by emphasizing the importance of preventing or treating diabetes
by modulating the intestinal absorption of glucose by dietary measures
(By decreasing the simultaneous ingestion of salt and sugar) or pharmacological
(Using molecules selectively inhibiting the sodium-glucose transporter
intestinal, the first results appear promising in humans).
This work was possible thanks to the financial support of: Fondation de l'Avenir
(ET2-665); Francophone Foundation for Diabetes Research; European
Genomic Institute for Diabetes (ANR-10-LabX-46); Regional Council of Nord-Pas
Calais-Picardie and European Commission (ERDF CARDIO-DIABETES 12003944).