Clinical Trials Study
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World J Gastroenterol. Dec 28, 2014; 20(48): 18427-18431
Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18427
Comparison of different gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus
Shao-Wei Xiong, Dong-Yun Zhang, Xian-Ming Liu, Zeng Liu, Fang-Ting Zhang
Shao-Wei Xiong, Xian-Ming Liu, Zeng Liu, Department of General Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Dong-Yun Zhang, Department of Chronic Noncommunicable Diseases, Baoan District Chronic Diseases Hospital, Shenzhen 518133, Guangdong Province, China
Fang-Ting Zhang, Central Laboratory, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
Author contributions: Xiong SW designed the research; Xiong SW, Liu XM, and Liu Z performed the research; Xiong SW and Zhang DY analyzed data and wrote the paper; and Zhang FT revised the paper.
Supported by The Basic Research Projects of Shenzhen R&D Funding in Science and Technology, No. JCYJ20130402113802233 and No. JC201005260209A
Correspondence to: Fang-Ting Zhang, Senior Technologist, Central Laboratory, Peking University Shenzhen Hospital, 1120 Lian Hua Road, Shenzhen 518036, Guangdong Province, China. fangtingzhang@126.com
Telephone: +86-755-83923333-3519 Fax: +86-755-83923333
Received: June 12, 2014
Revised: August 1, 2014
Accepted: September 12, 2014
Published online: December 28, 2014
Abstract

AIM: To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.

METHODS: A retrospective analysis of the clinical data of 54 patients with gastric cancer and type 2 diabetes mellitus treated in the Department of General Surgery from January 2006 to June 2013 was conducted. The patients underwent gastrectomy using different Roux-en-Y gastric bypass procedures (traditional, n = 26; modified, n = 28). Fasting plasma glucose (FPG), two hour postprandial blood glucose (2 h PBG) and hemoglobin A1c (HbA1c) were analyzed before surgery (0 mo) and 1, 3 and 6 mo after surgery.

RESULTS: FPG and 2 h PBG levels were significantly decreased 1 mo after surgery in the traditional Roux-en-Y gastric bypass group (FPG 7.5 ± 1.3 vs 10.7 ± 1.2, P < 0.05) (2 h PBG 10.2 ± 1.8 vs 13.8 ± 3.2, P < 0.05). FPG and 2 h PBG levels were significantly decreased after surgery in the modified Roux-en-Y gastric bypass group (FPG 6.9 ± 1.2 vs 10.5 ± 1.1, 6.5 ± 1.3 vs 10.5 ± 1.1, 6.4 ± 1.2 vs 10.5 ± 1.1, P < 0.05) (2 h PBG 9.9 ± 2.2 vs 14.1 ± 2.9, 9.2 ± 2.4 vs 14.1 ± 2.9, 8.9 ± 2.6 vs 14.1 ± 2.9, P < 0.05). Compared with the levels before surgery, HbA1c levels were significantly decreased 3 and 6 mo after surgery (7.2 ± 1.1 vs 10.5 ± 1.1, 5.5 ± 1.1 vs 10.5 ± 1.1, P < 0.05). Significant differences between the two groups regarding FPG, 2 h PBG and HbA1c concentration were observed 3 and 6 mo after surgery (FPG 10.1 ± 1.5 vs 6.5 ± 1.3, 10.3 ± 1.4 vs 6.4 ± 1.2, P < 0.05) (2 h PBG 13.1 ± 2.8 vs 9.2 ± 2.4, 13.6 ± 3.1 vs 8.9 ± 2.6, P < 0.05) (HbA1c 10.1 ± 1.4 vs 7.2 ± 1.1, 10.5 ± 1.3 vs 5.5 ± 1.1, P < 0.05).

CONCLUSION: Modified Roux-en-Y gastric bypass can improve glucose metabolism in type 2 diabetic patients with gastric cancer.

Keywords: Roux-en-Y gastric bypass, Type 2 diabetes mellitus, Gastric cancer, Fasting plasma glucose, Hemoglobin A1C

Core tip: Type 2 diabetes mellitus (T2DM) is a common chronic disease and is a threat to public health. Modified Roux-en-Y gastric bypass surgery, which results in weight loss and a hypoglycemic effect, has been used in the treatment of patients with T2DM and obesity. However, the therapeutic mechanism involved is unclear. The aim of this study was to evaluate the efficacy of two Roux-en-Y gastric bypass procedures (traditional and modified) on blood glucose control in patients with T2DM and gastric cancer. It is suggested that modified Roux-en-Y gastric bypass may improve glucose metabolism in T2DM patients more effectively than the traditional procedure.