Effects of perioperative early enteral nutrition and glycemic control in patients with diabetes mellitus complicated with gastric cancer

doi:10.4240/wjgs.119258

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Sep 27, 2026; 18(9): 119258
Published online Sep 27, 2026. doi: 10.4240/wjgs.119258

Effects of perioperative early enteral nutrition and glycemic control in patients with diabetes mellitus complicated with gastric cancer

Li-Yan Zhang, Li-Chun Duan, Ming-Fang Xue, Chun-Yan Lang

Li-Yan Zhang, Department of CDC, The 964^th Hospital of PLA Joint Logistic Support Force, Changchun 130062, Jilin Province, China

Li-Chun Duan, Department of Dietary, The 964^th Hospital of PLA Joint Logistic Support Force, Changchun 130062, Jilin Province, China

Ming-Fang Xue, Department of Dietary, Jilin Province FAW General Hospital, Changchun 130011, Jilin Province, China

Chun-Yan Lang, Department of Endocrinology, The 964^th Hospital of PLA Joint Logistic Support Force, Changchun 130062, Jilin Province, China

Co-first authors: Li-Yan Zhang and Li-Chun Duan.

Author contributions: Zhang LY and Duan LC designed the research and wrote the first manuscript, they contributed equally to this article, they are the co-first authors of this manuscript; Zhang LY, Duan LC, and Xue MF contributed to conceiving the research and analyzing data; Zhang LY, Duan LC, and Lang CY conducted the analysis and provided guidance for the research; and all authors reviewed and approved the final manuscript.

AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the 964^th Hospital of PLA Joint Logistic Support Force, approval No. Y-20260414-005.

Informed consent statement: The requirement for written informed consent was waived due to retrospective design of the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Corresponding author: Chun-Yan Lang, Associate Chief Physician, Department of Endocrinology, The 964^th Hospital of PLA Joint Logistic Support Force, No. 4799 Xian Road, Lvyuan District, Changchun 130062, Jilin Province, China. alzccvbnm@163.com

Received: April 10, 2026
Revised: May 19, 2026
Accepted: July 1, 2026
Published online: September 27, 2026
Processing time: 157 Days and 23.4 Hours

Abstract

BACKGROUND

Patients with type 2 diabetes mellitus (T2DM) complicated with gastric cancer (GC) may experience hyperglycemia, malnutrition, and decreased immunity perioperatively. Without timely intervention, these conditions may negatively affect patients’ postoperative recovery.

AIM

To investigate the effects of perioperative early enteral nutrition (EEN) combined with glycemic control in patients with T2DM complicated with GC.

METHODS

A total of 99 patients with T2DM complicated with GC admitted to Chinese People’s Liberation Army 964 Hospital between May 2023 and May 2025 were enrolled. Patient were grouped according to postoperative intervention regimens: The control group (n = 48) received EEN combined with standard glycemic control, whereas the research group (n = 51) received EEN combined with intensive glycemic control. Clinical data were comparatively analyzed, including glycemic parameters (e.g., fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin), nutritional indicators (e.g., prealbumin, transferrin, and total protein), humoral immunity indices (immunoglobulin A/M/G), recovery indicators (e.g., wound healing time, time to first passage of flatus, and length of hospitalization), and complications (e.g., hypoglycemia, urinary infection, incision infection, and intestinal obstruction).

RESULTS

Compared with the control group, the research group showed significantly lower glycemic parameters, shorter wound healing time, time to first passage of flatus, and length of hospitalization, higher levels of prealbumin, transferrin, total protein, and humoral immunity indicators, and comparable overall incidence of complications after treatment.

CONCLUSION

Perioperative EEN combined with intensive glycemic control in patients with T2DM complicated with GC helps reduce blood glucose levels, improve nutritional and humoral immune function, and promote recovery without significantly increasing the overall risk of complications.

Keywords: Type 2 diabetes mellitus; Gastric cancer; Perioperative period; Early enteral nutrition; Glycemic control

Core Tip: This non-randomized retrospective cohort study analyzed the effects of perioperative early enteral nutrition (EEN) combined with glycemic control in patients with type 2 diabetes mellitus complicated with gastric cancer, using EEN combined with standard glycemic control serving as the control intervention. Comparative analyses demonstrated that perioperative EEN combined with intensive glycemic control was more effective than EEN combined with standard glycemic control. Specifically, the former intervention more effectively controlled blood glucose, improved nutritional status and humoral immune function, and promoted early recovery without increasing the overall incidence of complications.