Christoffer Martinussen - Reaching the effects of gastric bypass on diabetes and obesity without surgery: Physiological role of intestinal nutrient sensing

Background: Obesity and type 2 diabetes represent a world-wide problem and their treatment is a growing concern. Roux-en-Y gastric bypass surgery (RYGB) is currently the most successful treatment with diabetes remission rates of 50-80 % and weight loss of 30% in obese individuals. Most importantly, mortality is reduced about 30 %. These results show that there are mechanisms within our own body that can cure diabetes and obesity.

Research question: After RYGB preabsorptive nutrients trigger a complex gut-brain feed-back axis, reducing energy intake and blood glucose levels. The mechanisms behind these observations remain poorly understood. The research question of the present project is: What precisely are the mechanisms behind enhanced release of gut hormones after gastric bypass and how can we mobilize them via nutritional or pharmacological means rather than surgery?

Hypothesis: The overall hypothesis, based on our previous studies and supported by observations from many other groups, is that exaggerated release of gut hormones plays a major role for diabetes remission and weight loss following RYGB.

Research plan and methodology: This PhD project will initially focus on exploring gut hormone release in RYGB operated patients and weight-matched controls in response to the nutritional subcomponents of dietary fat and carbohydrates as well as the response to mixed meals when absorption of fat and/or glucose is inhibited.

Innovative aspects and future direction of the study: The results will describe the nutritional elements responsible for the exaggerated hormone responses after RYGB and will be used to propose and develop new approaches to activate secretion of the endogenous hormones as a treatment of obesity and type 2 diabetes.