Bernlohr, David A.
Bariatric Surgery and Inflammation
General Research Subject: Type 2 Diabetes
Focus: Adipocytes, Insulin Action\Insulin Resistance, Integrated Physiology, Obesity\Pathogenesis
Type of Grant: Clinical Translational Research
Project Start Date: July 1, 2011
Project End Date: June 30, 2014
Diabetes Type: Type 2 diabetes
Obesity is an epidemic that is associated with many medical problems such as type II diabetes. It is a disease characterized by inflammation especially at the level of the fat tissue. A common operation for obesity is a gastric bypass. In patients with type II diabetes who undergo gastric bypass, a dramatic improvement in their glucose and their insulin levels within days after surgery has been observed. These observations are made long before significant weight loss. An understanding of why this happens may uncover important targets for therapy of type II diabetes. This research focuses on the relationship between the inflammation of fat tissue and changes after surgery. Preliminary data shows that inflammation of the fat tissue appears less aggressive after the gastric bypass and as a result the fat tissue appears to function more normally. The whole body resistance to insulin appears to be reduced during this short time frame. The proposal is to study the effects of the gastric bypass on patients by measuring the types of immune cells in their fat tissue before and after surgery. In order to test if these changes are related to diet alone this study will test the hypothesis in patients who receive significant reduction in food without undergoing surgery. It is suspected that the inflammation will get worse if we give patients a high-fat diet and will test this hypothesis also.
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?
Improvement in control of glucose and insulin levels in patients with type 2 diabetes following the Roux en Y gastric bypass (RYGB) has drawn much attention as a viable anti-diabetes treatment. However, it is not clear if the changes in glucose and insulin levels that are achieved via RYGB are due to the surgical procedure or if they originate from the reduced food intake that accompanies surgery. Our study addresses how bariatric surgery affects insulin and glucose by comparing patients undergoing surgery to a control group who have a parallel reduction in food intake. We will evaluate patients 10 days after surgery—a time chosen for there is little if any significant weight loss. We will also test the hypothesis that there is a reduction in inflammation occurring after RYGB surgery by profiling the accumulation of inflammatory cells and oxidative stress markers in both surgical and reduced food control patients.
These studies may shed light on the differences between gastric bypass and food reduction as therapies to improve the lives of those with type 2 diabetes.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?
Our study will help physicians determine if a surgical treatment or if food reduction is the best therapy towards improving the quality of life for diabetics. Moreover, our work on oxidative stress and inflammation may lead to other new therapies.
Why is it important for you, personally, to become involved in diabetes research? What role will this award play in your research efforts?
My laboratory has a long-standing commitment to diabetes research and has studied the relationship of obesity to type 2 diabetes for over 2 decades. This award will allow us to translate our basic science findings using animal models to clinical investigation and hopefully to the patient. The award will allow us to test hypotheses about the biology of diabetes previously analyzed in mouse models to human patients so that hopefully new treatments and therapies can be developed.
In what direction do you see the future of diabetes research going?
I see diabetes research in the future being more tailored to the individual than to the masses. Individualized medical treatments attained with improved knowledge and understanding of the disease will hopefully improve the quality of life for many people for decades.
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