Ileal transposition controls diabetes as well as modified duodenal jejunal bypass with better lipid lowering in a nonobese rat model of type II diabetes by increasing GLP-1.

Objective: Modified duodenal jejunal bypass (MDJB) and ileal transposition (IT) were compared as surgeries for glucose control. Initial conclusions might be formed with respect to the possibility of (1) whether duodenal exclusion is essential for the control of diabetes and (2) application as a low morbid procedure.

Summary Background Data: IT, MDJB, sham-IT, and sham-MDJB procedures were performed on 10- to 12-week-old Goto-Kakizaki (GK) rats, nonobese animals who spontaneously develop type 2 diabetes. Rats were observed for 24 weeks after surgery. Glucose, insulin, glucagon-like peptide-1 (GLP-1), glucose tolerance, insulin sensitivity, cholesterol, triglycerides, and free fatty acid levels were measured.

Results: MDJB and IT rats, when compared with sham-operated rats, showed reduced blood-glucose levels (P < 0.001); but IT- and MDJB did not differ from one another (P < 0.05). Compared with sham-operated rats, IT- and MDJB rats showed increased GLP-1 secretion (P < 0.01), with a more rapid and higher secretion in IT operated than in MDJB rats (P < 0.05). After 6 months, sham-operated rats weighed more than IT or MDJB rats (P < 0.01), but the weights of IT- and MDJB rats were similar to one another (P > 0.05). In terms of both operative time (P < 0.001) and postoperative recovery time (P < 0.001), MDJB took longer than did IT.

Conclusion: In nonobese spontaneously diabetic rats, IT is equivalent to MDJB in terms of glucose control and weight secondary to significant increases of GLP-1. IT is faster to perform and yields a shorter recovery period than does MDJB.