The better effect of Roux-en-Y gastrointestinal reconstruction on blood glucose of nonobese type 2 diabetes mellitus patients

摘要

BACKGROUND: Given the role of gastrointestinal reconstruction, we investigated whether Roux-en-Y gastrointestinal reconstruction (RYGR) and Billroth I reconstruction (B1R) can improve glucose in nonobese type 2 diabetes mellitus patients. METHODS: Seventy-six nonobese type 2 diabetes mellitus patients underwent open subtotal gastrectomy with RYGR and B1R between January 2005 and January 2010 in our hospital. Besides demographic data, preoperative weight, glucose, hemoglobin A1c, ghrelin, and glucagon-like peptide 1 were determined. RESULTS: As defined previously, 2 of 35 patients with RYGR were cured, 5 patients were controlled, and 10 patients were improved; similarly, 2 of 41 patients with B1R were controlled, and 3 patients improved 12 months after surgery. The fasting glucose and hemoglobin A1c decreased more significantly in RYGR patients (P <.05). Moreover, a higher fasting plasma GLP-1 level in RYGR patients and lower ghrelin in B1R patients were noted after surgery (P <.05). CONCLUSIONS: RYGR shows a more effective amelioration in nonobese type 2 diabetes mellitus patients.