The effects of bilio-jejunal diversion on streptozotocin diabetes in the rat.

Previous experimental indications that the internal biliary diversion (IBD), consisting in bilio-jejunal anastomosis, provokes an increase in glucose tolerance in healthy rats provide the basis for testing the hypothesis that this surgical procedure is capable of correcting pharmacologically-induced diabetes mellitus. To this object, the carbohydrate metabolism of an experimental group of six rats suffering from streptozotocin diabetes and treated with IBD (Lambert prosthetic choledoco-jejunostomy) was studied and compared with that of three control groups: normal, diabetic without surgery and diabetic with sham-surgery. Carbohydrate metabolism, assessed during 60-day period by means of specific tests (basal and fasting blood glucose and insulin, glucose tolerance and insulin sensitivity), demonstrated that the IBD provokes a definitive remission, either total or partial, of the artificial diabetes mellitus. The results lead to the hypothetical explanation that diversion of bile flow from the duodenum to the proximal jejunum activates the 'entero-insular axis', specifically by potentiating the B-cell stimulating effect of the so-called enteric hormone 'incretin'.