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Efficacy of modified Roux-en-Y gastric bypass in the treatment of non-obese type 2 diabetes mellitus:one year follow-up

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Author:
No author available
Journal Title:
Chinese Journal of Surgery
Issue:
10
DOI:
10.3760/cma.j.issn.0529-5815.2012.10.004
Key Word:
糖尿病,2型;胃旁路;随访研究;Diabetes mellitus,type 2;Gastric bypass; Follow-up studies

Abstract: Objective To evaluate the one year effect of modified Roux-en-Y gastric bypass (RYGP) in the treatment of non-obese type 2 diabetes and to investigate the reasonable indications for surgery.Methods Totally 72 patients diagnosed as type 2 diabetes underwent RYGP from May 2009 to June 2010. There were 45 male and 27 female patients,with an average age of (47 ± 10 ) years.Preoperative body mass index (BMI) of the patients was 18.69 to 31.22 kg/m2,average (26 ±4) kg/m2.The follow-up data included fasting plasma glucose (FPG),2 h plasma glucose after oral glucose challenge (2hPG),weight,BMI and medication usage in 1,3,6 and 12 months postoperative; hemoglobin Alc (HbA1c),fasting C-peptide (C-P),fasting serum insulin (Fins) and homeostasis model assessment of insulin resistance index (HOMA-IR) in 6 and 12 months postoperative,respectively.Results Compared with the preoperative,FPG,2hPG,weight and BMI in 1,3,6 and 12 months after surgery were improved (t =7.014 to 10.254,P =0.000),while HbAlc,C-P and HOMA-IR in 6 and 12 months after surgery were improved ( t =1.782 to 7.789,P =0.000 to 0.103 ) and there was no significant difference in Fins (P>0.05). The rates of complete remission in 1,3,6 and 12 months after surgery were gradually improved to 22.2%,27.8%,36.1% and 60.6%,respectively,and the rate of remission in 1 year was 94.3%.The complete remission of 1 year after surgery was associated with normal C-P,insulin antibody and oral antidiabetic drugs ( x2 =11.730,P =0.003 ; x2 =7.131,P =0.028 ; x2 =6.149,P =0.046).Conclusions Modified RYGP is safely and effectively in the treatment of no-obese type 2 diabetes patients.The function of islet cells is significantly improved after operation.Especially for the patients of whom C-P is normal,insulin antibody is negative before surgery,the rate of complete remission after 1 year is better.

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