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from the big-pharma-ain't-gonna-like-this dept.
A team from Newcastle University, UK, has shown that Type 2 diabetes is caused by fat accumulating in the pancreas -- and that losing less than one gram of that fat through weight loss reverses the diabetes.
Affecting two and a half million people in the UK -- and on the increase -- Type 2 diabetes is a long-term condition caused by too much glucose, a type of sugar, in the blood.
...
In a trial, 18 people with Type 2 diabetes and 9 people who did not have diabetes were measured for weight, fat levels in the pancreas and insulin response before and after bariatric surgery. The patients with Type 2 diabetes had been diagnosed for an average of 6.9 years, and all for less than 15 years.The people with Type 2 diabetes were found to have increased levels of fat in the pancreas.
The participants in the study had all been selected to have gastric bypass surgery for obesity and were measured before the operation then again eight weeks later. After the operation, those with Type 2 diabetes were immediately taken off their medication.
Both groups lost the same amount of weight, around 13% of their initial body weight. Critically, the pool of fat in the pancreas did not change in the non-diabetics but decreased to a normal level in those with Type 2 diabetes.
Good news for people with Type 2 diabetes and puts more importance on sticking to New Year's resolutions to lose weight.
(Score: 2) by rleigh on Friday December 04 2015, @05:54PM
Why would you say MRI is good for the brain, but not for the abdomen? It can be used to image any volume in the body, and using multiple chemical shifts (possibly also with contrast agents) can be used to differentiate between different bulk properties, e.g. bone vs muscle vs blood; it could absolutely specifically pick up lipid/adipose tissue. Here's a paper demonstrating just that: http://www.ncbi.nlm.nih.gov/pubmed/23255760 [nih.gov] and it even differentiates between white and brown adipose tissue. I've even seen MRIs on teeth picking out all the different tissue layers.
The resolution of a typical medical MRI scan starts around 1mm^3, and it can be increased if desired (e.g. bigger magnet, longer scan time to increase the signal:noise of the smaller volume). The density of adipose tissue is ~0.9g/ml, so a 1g mass difference equates to a whopping 1.111ml volume change, i.e. ~1111 voxels (and it could be much more precise than that, since you can have much smaller voxels and you're also quantifying the amount /within/ each voxel). That can be measured very accurately, and since these patients are being monitored over time, we can see the /specific/ changes in the pancreatic size and structure very well. That's not "bullshit", it's the reality of what the instrument is capable of.
"If one gram of pancreatic fat was the real problem, insulin would work for these people." What? Of course it would; these people were previously diabetics on treatment. That "works for" these people as a prophylactic, not a cure. As the article explains, the patients' diabetes was reversed, and treatment was stopped. If the pancreas is producing insulin normally, then there is of course no need to continue treatment with insulin. I don't see what this comment has to do with the article.
Now, you do have a point regarding "correlation vs causation". It's not definitively proven that the 1g fat loss was the cause of the resuming of normal pancreatic function. But it strongly correlates, and it paves the way for future investigation to determine the precise mechanism by which fat accumulation causes pancreatic dysfunction. There's a reason for this; can you think of a practical means to test the hypothesis? Medical ethics and getting volunteers is a big part of the problem; there's a reason why this was done non-invasively on volunteers who were already scheduled for the surgery. Could you even do it invasively, but excising the fat tissue from the pancreas? Unlikely, since it would be very difficult to surgically remove--it's an integral part of the organ--and the danger for the patient would be severe. It's /strongly suggestive/ that the /specific/ fat loss in the pancreas returned it to normal function.
Your comments come across as being incredibly dismissive of this work. Yes, a small change in the fat content of the organ might sound small, but if it accumulates in the "wrong" place, could it have a profound effect upon the functioning of an organ? Yes, it absolutely could. And since the pancreas is relatively small, that's potentially a significant change to its physiology. Could the massive systemic changes in fat mobilisation following e.g. gastic band surgery or an exercise/weight loss programme cause fat loss in the pancreas and other organs. Yes. Are the mechanisms fully understood? No. But we don't need to understand every last detail of the mechanism to know that the /treatment/ leads to an /effective and beneficial clinical outcome/. So what if we don't know that the fat loss causes the return to function; the patients lost weight, including loss of pancreatic fat, and their pancreas' started working again. That's a big deal. Look at the amount of increasing obesity and diabetes in the modern world; it's truly shocking, and this is an incredibly important finding which could improve the quality of life for millions.