LETTERS Paradoxical responses

of plasma glucagon and bile acid levels after duodenal nutrient exclusion Dear Sir, We read with interest the article by Habegger et al1 who demonstrated that duo-denal nutrient exclusion using duodenal endoluminal sleeve (DES) improves meta-bolic syndrome and stimulates intestinal villus hyperplasia, especially the bypassed duodenum, in a rodent model of type 2 dia-betes mellitus. There were three intriguing results. First, with regard to DES improving glucose homeostasis, the area under curve analysis showed that both sham-operate