Abstract
AbstractDiabetes mellitus (DM) type 2 now afflicts over 170 million people worldwide, a number expected to surpass 220 million by 2010. DM and its associated complications is a significant burden to public health care funding.In 2007, $US174 billion was spent in the United States, according to the American Diabetic Society. The morbidly obese have high serum leptin and insulin levels and low ghrelin levels, which have been associated with altered satiety. Exercise, medical therapy and dieting usually do not result in long‐term weight loss or euglycemia. Bariatric surgery yields euglycemia for many patients, but its mechanism has yet to be fully elucidated. Our preliminary studies showed resolution of DM after both gastric bypass (GBP) and sleeve gastrectomy (SG), more so than after gastric banding. GBP significantly reduces ghrelin levels in the morbidly obese, perhaps as a result of exhausting ghrelin production in the stomach. A reduction in serum ghrelin levels would be expected after SG, which extirpates the ghrelin‐producing cells by removing the fundus. This question has not, to our knowledge, been fully explored with regard to the relationship between ghrelin and other hormones.
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