Longer-term management highlights the need for effective approaches to dietary advice. In this issue (https://doi.org/10.1007/s00125-017-4450-9), Jorsal et al report the results of anterograde and retrograde double-balloon enteroscopy with frequent mucosal biopsy retrieval (every 30 cm) along the entire intestinal tract in 12 individuals with type 2 diabetes and 12 healthy individuals.
Based on such evidence, bariatric operations are now being repurposed as specific therapy for type 2 diabetes, a practice dubbed 'metabolic surgery'.
In a review in this issue (https://doi.org/10.1007/s00125-017-4513-y), Cummings and Rubino summarise mechanistic and clinical evidence supporting new guidelines developed during the second Diabetes Surgery Summit, an international consensus conference, for use of metabolic surgery.
The critical role of family and social circle in achieving sustainable changes in food habits is considered. Furthermore, they show differences between healthy and type 2 diabetic individuals in distribution patterns and expression profiles of K and L cells. Whether the pursuit of intensive glycaemic control to reduce the rate of chronic kidney disease (CKD) is worth the effort, cost and patient burden is an important clinical question that many trials have tried to answer.
The figures from this review are available as a downloadable slideset. These findings provide a reference work for scientists and clinicians and may promote the understanding of the integrative role of the gut in the regulation of glucose metabolism and appetite. In this issue (https://doi.org/10.1007/s00125-017-4473-2), Agrawal et al report the results of an analysis of the Veterans Affairs Diabetes Trial (VADT) and follow-up study.
[Text supplied by the authors.] Download a pdf **************************** The aetiology of type 2 diabetes can now be simply described.
The 2008 twin cycle hypothesis postulated that chronic energy excess leads to a vicious cycle progressively driving up liver fat content, increasing export of triacylglycerols to the pancreas and, in susceptible people, ultimately results in failure of the acute insulin response. [Text supplied by the authors.] Download a pdf **************************** Enteroendocrine K and L cells in healthy and type 2 diabetic individuals by Tina Jorsal, Nicolai A. [Text supplied by the authors.] Download a pdf **************************** Long-term follow-up of intensive glycaemic control on renal outcomes in the Veterans Affairs Diabetes Trial (VADT) by Lily Agrawal, Nasrin Azad, Gideon D. Participants had advanced type 2 diabetes and prevalent cardiovascular disease, and received excellent blood pressure and lipid management. Knop Long-term follow-up of intensive glycaemic control on renal outcomes in the Veterans Affairs Diabetes Trial (VADT) Short Communication Lily Agrawal, Nasrin Azad, Gideon D. Intensive glycaemic control for a median of 5.6 years resulted in significantly more people maintaining an e GFR above 60 ml min for up to almost 11 years. In this issue (https://doi.org/10.1007/s00125-017-4288-1), John Wilding reviews the effects of different diabetes medications on body weight, and discusses how a weight-focussed approach to diabetes treatment, including appropriate use of glucose-lowering medicines that help weight loss, and anti-obesity medication, can help optimise outcomes for people with diabetes and obesity. Many novel medicines for obesity and diabetes, including combinations of drugs with complementary modes of action, are in development and may result in a much greater emphasis on this approach in the future. Dr Billroth (1829-1894) pioneered gastrectomies for ulcers and cancer. Hoffmann, Cecilia Nigro, Paola Mirra, Francesca Fiory, Pietro Formisano, Claudia Miele, Ulf Smith, Francesco Beguinot Back to top of this issue list Enterovirus-associated changes in blood transcriptomic profiles of children with genetic susceptibility to type 1 diabetes Niina Lietzen, Le T. Elo Oral histone deacetylase inhibitor synergises with T cell targeted immunotherapy to preserve beta cell metabolic function and induce stable remission of new-onset autoimmune diabetes in NOD mice Alix Besançon, Tania Goncalves, Fabrice Valette, Mattias S.