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allied
academies
Nov 22-23, 2018 | Paris, France
Joint Event
Nutrition and Health
16
th
International Conference on
26
th
International Conference on
Diabetes and Endocrinology
&
Journal of Insights in Nutrition and Metabolism | Volume 2
The reversal of type 2 diabetes - The role of the bile
Gerald H Tomkin
Beacon Consultant Clinic, Ireland
T
ype 2 diabetes is a complex disorder. A relative rather
than an absolute lack of insulin allows blood sugar to
rise above normal even though the patients secret excess
insulin. This is termed insulin resistance and is preceded by a
hyperinsulinemia phasewhere blood sugars still remain normal.
The hyperinsulinemia reflects good islet cell function even if
not sufficient to control hyperglycaemia. At this stage in the
disease there is an opportunity to reduce insulin resistance and
to improve beta cell function and to control/reverse diabetes.
Bile plays an important regulatory function in carbohydrate
and fat metabolism and signals beta cell stimulation and insulin
secretion. Abnormalities in bile have been well documented in
obesity and type 2 diabetes, and alterations have been shown
with weight reduction and following bariatric surgery. Reversal
of diabetes has been shown to occur following lifestyle changes
and weight reduction and the recent. Direct study has shown
thatmany obese patients are able to followameaningful weight
reduction program with 85% of patients who lose more than
15% of body weight being able to reverse their diabetes. Most
dietary programs prior to this study, incurred large expenditure
but the direct study showed the possibility of general practice
being able to deliver a program with little in the way of cost
implications. The research showed that about 25% of obese
patients with type 2 diabetes were willing and able to complete
a year’s program, with many being successful in reversing their
diabetes. Bariatric surgery has a similar impact on diabetes
reversal. It is of course more successful in weight reduction in
that more patients will lose more than 15% of body weight but
at a cost of more complications and a greater financial cost. The
role of pharmaceutical agents in preserving beta cell function,
improving satiety and diminishing hunger will be discussed
.
e:
gerald.tomkin@tcd.ie