To conclude, we hypothesise that exclusion of the foregut by means of an EndoBarrier device will improve glycaemic control, above that of conventional medical therapy, diet and exercise via (1) decreased hepatic insulin resistance and increased insulin production that occur independent of weight loss and caloric restriction, and (2) reduction in total body and tissue-specific insulin resistance as a result of consequent weight loss. The gene discussed is INS; the disease is Insulin resistance.