Brief Article
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World J Gastroenterol. Dec 28, 2013; 19(48): 9410-9417
Published online Dec 28, 2013. doi: 10.3748/wjg.v19.i48.9410
Improvement of type 2 diabetes mellitus after gastric cancer surgery: Short-term outcome analysis after gastrectomy
Ji Yeong An, Yoo Min Kim, Min Ah Yun, Byeong Hee Jeon, Sung Hoon Noh
Ji Yeong An, Min Ah Yun, Sung Hoon Noh, Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul 120-752, South Korea
Yoo Min Kim, Department of Surgery, Dong-A University College of Medicine, Busan 602-715, South Korea
Byeong Hee Jeon, Department of Clinical Care, Graduate School of Nursing, Yonsei University, Seoul 120-752, South Korea
Author contributions: An JY contributed to conception and design and wrote the manuscript; An JY and Kim YM made substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data, participated in drafting the article with important intellectual content; Yun MA and Jeon BH collected data and contributed to the review/edited the manuscript; Noh SH participated in revising this article critically for important intellectual content.
Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology, 2011-0011301; a faculty research grant of Yonsei University College of Medicine for 2011, 6-2011-0084
Correspondence to: Ji Yeong An, MD, PhD, Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. ugids@naver.com
Telephone: +82-2-22282095 Fax: +82-2-3138289
Received: May 10, 2013
Revised: October 21, 2013
Accepted: November 2, 2013
Published online: December 28, 2013
Abstract

AIM: To evaluate the effect of gastrectomy on diabetes control in patients with type 2 diabetes mellitus and early gastric cancer.

METHODS: Data from 64 patients with early gastric cancer and type 2 diabetes mellitus were prospectively collected. All patients underwent curative gastrectomy (36 subtotal gastrectomy with gastroduodenostomy, 16 subtotal gastrectomy with gastrojejunostomy, 12 total gastrectomy) and their physical and laboratory data were evaluated before and 3, 6 and 12 mo after surgery.

RESULTS: Fasting blood glucose (FBS), HbA1c, insulin, C-peptide, and homeostasis model assessment-estimated insulin resistance were significantly improved 3 mo after surgery, regardless of operation type, and the significant improvement in all measured values, except HbA1c, was sustained up to 12 mo postoperatively. Approximately 3.1% of patients stopped diabetes medication and had HbA1c < 6.0% and FBS < 126 mg/dL. 54.7% of patients decreased their medication, and had reduced FBS or HbA1c. In multivariate analysis, good diabetic control was not associated with operation type, but was associated with diabetes duration.

CONCLUSION: Diabetes improved in more than 50% of patients during the first year after gastric cancer surgery. The degree of diabetes control was related to diabetes duration.

Keywords: Type 2 diabetes mellitus, Gastrectomy, Gastric cancer, Short-term outcome, Glucose control

Core tip: Diabetes mellitus is one of the most important health problems and has an impact on the quality of life of gastric cancer patients as well as ordinary individuals. In this study, we evaluated the impact of conventional gastric cancer surgery on type 2 diabetes. Gastric cancer surgery led to a significant improvement in type 2 diabetes during the first year after surgery, and the degree of diabetes control was related to diabetes duration.