As we wrote back in 2008, the EndoBarrier is a very clever way to simulate the effect of a gastric bypass without the unpleasant scalpel part. It looks like a long clear plastic stocking, and it's simply threaded through the patient's mouth and stomach, down to the small intestine, where it lines the intestine's upper section (the same part that is bypassed in traditional surgery). Food slips right through it, but digestive enzymes are trapped on its other side. The two don't get to join forces until a couple of feet further downstream, so the effect on diabetes is a lot like that of a bypass: It resolves the symptoms of type 2 diabetes.
Michael Hamman is a 63-year-old contractor. He recalls, "I first was diagnosed with type 2 diabetes five or six years ago. I probably had elevated blood sugar well in advance of that, but I was unaware of it. I don't remember how high my blood sugar was at the time, but I think my A1C was 7.5%. My blood sugar's never really been awful. Since I started monitoring myself, my sugar readings are normally between 150 and 165. I think it was pushing 200 before I was medicated, but the medications brought it down. They started me on glyburide and I took that for a long time, and then the A1C was moving up again, so they added the metformin. The A1C now is down in the mid-sixes. They consider it controlled, not well controlled or as good as it could be, but certainly for someone my size, it's probably as good as you can get."
Tony Flores is a 50-year-old native of El Salvador who works as a construction foreman. He was diagnosed with type 2 diabetes about 12 years ago, after an eye doctor told him it would be a good idea to get his blood sugar checked. He recalls, "I did the test, and they got all freaked out and told me, ‘Oh my god, your A1C is at 12%. You have diabetes type 2. You've got to cut the sugar, you've got to stop drinking orange juice and soda."
You know that awful feeling when a sugar low is coming. I break out into a cold sweat, feel panicky, get nauseated, and have trouble answering extremely simple questions like "Do you need to eat?" Well, I was feeling it again, and again, and I didn't know why. That's what I hate the most: When things go wrong, but I think I've been doing everything right.
Ellen Granberg is an obesity sociologist who studies the processes that people go through when they lose weight and keep it off. As she says, "If the problem were that we don't know what people should eat to lose weight, that would be one thing, but we don't have that problem. There are a hundred weight loss plans out there that are perfectly good. We understand all about the physiology of weight loss maintenance and the metabolic impacts, but nothing about the social and emotional impacts. People who sustain weight loss over time move through a lot of different challenges."
In order to undergo gastric bypass surgery, you must have a BMI of at least 35. If you have type 2 diabetes and would like to undergo the surgery to alleviate your diabetes symptoms, you are out of luck unless you are also morbidly obese. A few less weighty type 2 patients have taken matters into their own hands by deliberately gaining enough weight to qualify, but now there is a less drastic way to qualify for the operation.
High fructose corn syrup (HFCS) is, as the name implies, corn syrup whose glucose has been partially changed into a different sugar, fructose. To make HFCS, you start with corn, then mill it to produce starch -corn starch. Starch, the most important carbohydrate in the human diet, consists of long chains of glucose. To make corn syrup, you mix the corn starch with water and then add an enzyme, produced by a bacterium, that breaks the starch down into shorter chains of glucose. Then you add another enzyme, produced by a fungus, that breaks the short chains down into glucose molecules. At that point, you have regular corn syrup.
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