andrepositif; Université de Lille / andrepositif; University of Lille

Le diabète, la recherche et l'accompagnement.

Diabetes, Research and Support

Quoi de neuf en recherche!

La recherche

Voici un communiqué de presse du Centre Hospitalier Régional Univeritaire de Lille.

andrepositif vous apporte les plus ressante nouvelles mondiale sur le diabète.



Lille, 25/02/2016

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

Functional bowel.


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).