Long-term Follow-up for Type 2 Diabetes Mellitus after Gastrectomy in Non-morbidly Obese Patients with Gastric Cancer: the Legitimacy of Onco-metabolic Surgery.
- Author:
Tae Hoon LEE
1
;
Chang Min LEE
;
Sungsoo PARK
;
Do Hyun JUNG
;
You Jin JANG
;
Jong Han KIM
;
Seong Heum PARK
;
Young Jae MOK
Author Information
- Publication Type:Original Article
- Keywords: Type 2 diabetes mellitus; Stomach neoplasms; Surgery; Reconstruction method; Glycemic index; Control
- MeSH: Body Mass Index; Diabetes Mellitus, Type 2*; Follow-Up Studies*; Gastrectomy*; Gastroenterostomy; Glycemic Index; Hemoglobin A, Glycosylated; Humans; Illegitimacy*; Methods; Retrospective Studies; Statistics as Topic; Stomach Neoplasms*
- From:Journal of Gastric Cancer 2017;17(4):283-294
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This study primarily aimed to investigate the short- and long-term remission rates of type 2 diabetes (T2D) in patients who underwent surgical treatment for gastric cancer, especially patients who were non-obese, and secondarily to determine the potential factors associated with remission. MATERIALS AND METHODS: We retrospectively reviewed the clinical records of patients with T2D who underwent radical gastrectomy for gastric cancer, from January 2008 to December 2012. RESULTS: T2D improved in 39 out of 70 (55.7%) patients at the postoperative 2-year follow-up and 21 of 42 (50.0%) at the 5-year follow-up. In the 2-year data analysis, preoperative body mass index (BMI) (P=0.043), glycated hemoglobin (A1C) level (P=0.039), number of anti-diabetic medications at baseline (P=0.040), reconstruction method (statistical difference was noted between Roux-en-Y reconstruction and Billroth I; P=0.035) were significantly related to the improvement in glycemic control. Unlike the results at 2 years, the 5-year data analysis revealed that only preoperative BMI (P=0.043) and A1C level (P=0.039) were statistically significant for the improvement in glycemic control; however, the reconstruction method was not. CONCLUSIONS: All types of gastric cancer surgery can be effective in short- and long-term T2D control in non-obese patients. In addition, unless long-limb bypass is considered in gastric cancer surgery, the long-term glycemic control is not expected to be different between the reconstruction methods.
