40 minute operation to beat diabetes

In patients with diabetes, blood glucose or sugar levels are above normal, the symptoms of this include unusual thirst, tiredness, loss of weight, increased appetite and blurred vision.

If lifestyle changes and medicines do not adequately control glucose levels, insulin injections may have to be started either temporarily or for the rest of the patient's life.

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In a clinical trial which is due to start this month, 50 patients are having the procedure, which has been shown to be effective in research on animals and on a small number of people.

In one study, some patients experienced big drops in blood-sugar levels almost immediately.

The treatment, known as duodenal exclusion, involves bypassing part of the upper small intestine or duodenum, so that food from the stomach goes directly into the lower small intestine.

Most food is turned into glucose which the body uses for energy. One of the duodenum's jobs is to break down fats, sugars and other compounds in the food before they get into the next part of the small intestine.

The nutrients are then absorbed into the body before the material passes into the colon.

One of the reasons the surgery may help to reduce diabetes symptoms is because it reduces the amount of food patients are able to digest. People who are overweight - with a body mass index over 25 - are more at risk of Type 2 diabetes.

In particular, people who are an apple shape - with lots of fat around the abdomen -are at greater risk of developing diabetes.

"If you bypass the duodenum you won't absorb food as well. There will be less digestion," says Professor David Matthews, a diabetes specialist at Oxford University.

An earlier study, in non-obese patients, reported that the procedure led to big improvements in two patients who had high glucose levels.

Their glucose levels were back to normal within four months of the operation.

In the trial, sponsored by U.S. Medical and taking place in Brazil, the patients, aged 20 to 65, will have the surgery and will then be monitored for a year.

Exactly how the surgery works is not clear. One theory is that, as well as reducing food absorption, it may have an impact on the hormones involved in regulating food intake.

Decreased levels of some hormones - which have resulted from the surgery in some cases - could have a beneficial effect on glucose.

Professor Matthews says: "It is worth doing the trial. Patients will lose weight and their diabetes will probably improve. It is an expensive way of approaching diabetes, but it should be effective in a lot of people, although some will get side-effects."

He adds: "One downside is that if you miss out the small intestine you can get excessive diarrhoea and some malabsorption, where you don't absorb vitamins properly."

Diabetes Type 2 is a significant and growing health problem. There are just under 1.9million adults with diagnosed diabetes in the UK, and it is estimated another 589,000 are yet to be diagnosed.

The risk increases with age - fewer than one per cent of people under 34 have diagnosed diabetes compared with 10 per cent of those aged 75 and over.

A spokesman for Diabetes UK said: "There is one theory that when this kind of surgery is done, the secretions from the stomach change, which somehow helps in diabetes.

"At the moment there is no cure for the disease, and that surgery is the last option. Diet and lifestyle are very important."

For more information on diabetes call 020 7424 1000.