It is interesting to note that RYGB exerts its main effect in inducing diabetes remission through the reduction of hepatic glucose production [15] and increased insulin secretion, while BPD acts essentially by normalizing insulin sensitivity The first phase insulin secretion is promptly normalized after BPD [21••], whereas it is significantly improved, but does not return to normality, after RYGB [22]. This evidence concerns the gene INS and diabetes mellitus.