Influence of gastrectomy for stomach cancer on type 2 diabetes mellitus for patients with a body mass index less than 30 kg/m2.
10.4174/jkss.2012.82.6.347
- Author:
Kyu Chul KANG
1
;
Seok Hwan SHIN
;
Yeon Ji LEE
;
Yoon Seok HEO
Author Information
1. Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Korea. gshur@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Type 2 diabetes mellitus;
Gastrectomy;
Gastric bypass;
Low BMI;
Body mass index
- MeSH:
Biomarkers;
Blood Glucose;
Body Mass Index;
Diabetes Mellitus;
Diabetes Mellitus, Type 2;
Fasting;
Follow-Up Studies;
Gastrectomy;
Gastric Bypass;
Hemoglobins;
Humans;
Retrospective Studies;
Stomach;
Stomach Neoplasms;
Weight Loss
- From:Journal of the Korean Surgical Society
2012;82(6):347-355
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The impressive effect of LRYGBP on mildly obese patients (30 kg/m2 < BMI < 35 kg/m2) with T2DM raises the argument for lowering the threshold for surgical intervention to non-obesity (BMI < 30 kg/m2). The goal of this study was to evaluate the effect of gastrectomy on non-obese patients with T2DM and what preoperative clinical factors are associated with postoperative long term improvement. METHODS: In this retrospective review, we analyzed the change in diabetic status in 75 patients with gastric cancer undergoing three different gastrectomies in a single institution from June 1996 to September 2009. Pre- and postoperative fasting blood glucose, serum hemoglobin A1c and diabetic medication requirements were compared. The demographic data and other biochemical markers were also collected. RESULTS: At an average follow-up of 35.0 +/- 25.9 months, we collected the data of 75 patients and evaluated the change of diabetes status. There was no resolution of diabetes in Billroth-I (B-I) group, and 45.2% of patients improved whereas the resolution rate of Billroth-II (B-II) and RY group was 22.2% and 23.5% and 85.2% and 88.2%, respectively. The improvement rate of diabetes mellitus (DM) status was 7.46 times higher in B-II than in B-I patients. The method of reconstruction is the most powerful factor and severity and duration of diabetes showed significant clinical factors for the improvement of the disease after surgery. CONCLUSION: According to these results, foregut-bypass procedure may improve the type 2 DM better than can be explained by the effect of weight loss only. Diabetes remission is significantly higher in those with duration of diabetes less than 5 years.
