Resumen de Diabetes: Have We Got It All Wrong?: Hyperinsulinism as the culprit: surgery provides the evidence

Walter J. Pories, G. Lynis Dohm

• [...]a view would be supported by the finding that basal-state hyperinsulinemia in healthy normoglycemic adults is predictive of T2DM over a 24-year followup (6). Because the focus of our hypothesis is on the initial cause of T2DM, our discussion is limited to early- and mid-stage disease, i.e., patients with FBS ^200 mg/dL. The primary manipulation in the surgery is exclusion of food from a portion of the GI track. [...]it seems reasonable to propose that a diabetogenic signal from the gut to the islets is the cause of hyperinsulinemia.