Paleo Diet and Paleolithic Diet Questions & Answers

Question

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I've read Taubes work on the carbohydrate hypothesis, Guyenet on food reward, and Becker on the Hypothalmic Hypothesis. My background is organic chemistry, not endocrinology or biochemistry, so much of the deep theory is a bit much for me.

Recent work in rats and humans has shown that Roux-en-Y Gastric Bypass rapidly resolves type 2 diabetes much faster than the corresponding drop in weight, proving that it's not caused by solely weight loss.

How does this factor in to how we think about T2D and obesity?

TNJ

flag	asked Nov 30 2011 at 0:29 TheNouveauJaeger 61●1

Beth-WeightMaven · Answer 1 · 2011-11-30 00:45:58Z UTC

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Here are a couple of papers that suggest weight loss surgery is not necessarily the panacea wrt diabetes:

Roux-en-Y is a pretty drastic surgery. It may or may not resolve obesity and/or diabetes. But it is a good bet to set someone up down the road for critical nutritional deficiencies. It makes me sad that it's something people feel compelled to do.

answered Nov 30 2011 at 0:45

Beth-WeightMaven
15.3k●1●11●55

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It should be called the, "Ruined n you want to Y now? Horrible operation only suited for those who are on deaths door from obesity. – The Quilt Nov 30 2011 at 1:12

Yupper my wife rotates on the bariatric floor of her hospital. Lots of return customers there. Tons of poor results that need multiple surgery and extended stays to try to rectify. – JayJay Nov 30 2011 at 2:13

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While I'm in no way encouraging these WLS surgeries, the mangling of the description of diabetes and insulin in that HAES piece is painful! In the second one, there's an interesting thing. If this one case had high ppBG but normal HbA1c, this would seem to support that pp glucose spikes don't lead to the dreaded glycation, it's the elevated chronic glucose. Is his diabetes "masked"? Perhaps he's a 1.5. – Evelyn aka CarbSane Nov 30 2011 at 12:07

Yeah, sorry bout that. What I like about it is that it makes the point that some of this diabetes "reversal" unrelated to weight loss is really related to the post-WLS VLC diet. – Beth-WeightMaven Nov 30 2011 at 13:04

Evelyn aka CarbSane · Answer 2 · 2011-11-30 12:00:22Z UTC

I think there's something about the incretins -- like GLP-1 -- that play a role in insulin signaling and may mimic insulin. The theory goes something like: more rapid delivery/more "bolus" delivery of nutrients to the ileum restores GLP-1 secretion that is impaired in diabetics.

I had just found a paper where GBP reversed diabetes in a non-obese animal model: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356425/

A non-surgical option there would be Byetta or Victoza -- both GLP-1 mimetics. Byetta produces weight loss, especially in the most obese. I would think this would be worth a shot before GBP for sure.

How does what we’ve learned from surgery (specifically Roux-en-Y) factor into how we think about Obesity and Type 2 Diabetes?

2 Answers