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Paradoxical responses of plasma glucagon and bile acid levels after duodenal nutrient exclusion
  1. Po-Chun Chen1,
  2. Akio Inui2,
  3. Chih-Yen Chen3,4
  1. 1Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  2. 2Department of Psychosomatic Internal Medicine, Kagoshima University Graduate, School of Medical and Dental Sciences, Kagoshima, Japan
  3. 3Division of Gastroenterology, Department of Medicine Taipei Veterans General Hospital, Taipei, Taiwan
  4. 4Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
  1. Correspondence to Dr Chih-Yen Chen, Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, Republic of China; chency{at}vghtpe.gov.tw

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Dear Sir,

We read with interest the article by Habegger et al1 who demonstrated that duodenal nutrient exclusion using duodenal endoluminal sleeve (DES) improves metabolic syndrome and stimulates intestinal villus hyperplasia, especially the bypassed duodenum, in a rodent model of type 2 diabetes mellitus. There were three intriguing results. First, with regard to DES improving glucose homeostasis, the area under curve analysis showed that both sham-operated and the DES group had statistically significant improvements in glucose homeostasis. Nevertheless, since the pair-fed group had received the same sham operation, it is interesting that the sham-operated group rather than the pair-fed group showed …

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