Blood glucose-lowering effect of different types of anastomosis in gastrojejunostomy on type 2 diabetes mellitus in Goto-Kakizaki rats

Abstract

Objective To investigate the effect after gastrojejunostomy with different types of anastomosis in an animal model of nonobese type 2 diabetes.Methods Twenty-four Goto-Kakizaki rats randomly underwent one of the following procedures:gastric bypass with different types of anastomosis of Roux-en-Y ( n = 8),Billroth Ⅱ ( n = 8 ) or Billroth Ⅰ ( n = 8 ).Rats were observed for 24 weeks after surgery.Fasting blood glucose and insulin level were tested at 0,1,3,6,12,24 weeks and homeostasis model assessment of insulin resistance (HOMA-IR) was done.Results As compared with preoperation,fasting blood glucose levels,the fasting blood insulin level and the HOMA-IR level had no significant change in Billroth Ⅰ rats during the entire follow-up period ( P ＞ 0.05).In both Roux-en-Y and Billroth Ⅱ groups,fasting blood glucose levels were significantly decreased as early as 1 week after surgery and then kept a similar level during the entire follow-up period (P＜0.01 ).Twenty-four weeks after operation,the fasting blood glucose levels was declined from (12.56 ±2.97),(12.96 ±3.01) mmol/L to (7.87 ±0.75),(9.21 ± 1.53) mmol/L;the fasting blood insulin levels were similar during the entire follow-up period ( P ＞0.05 ).The HOMA-IR level was significantly decreased after surgery in both Roux-en-Y and Billroth Ⅱ groups during the follow-up period ( P＜0.01 ).Twenty-four weeks after operation,the HOMA-IR level was declined from (11.92 ± 1.45),(12.69 ±2.03) to (6.66 ± 1.25),(7.97 ±0.68).Conclusion Billroth Ⅰ reconstruction after gastrectomy is not effective on diabetes control.Roux-en-Y and Billroth Ⅱ gastric bypass in a nonobese diabetic model were effective in terms of glucose control and improving insulin resistance.But Roux-en-Y gastric bypass seems to be more effective than Billroth Ⅱ gastric bypass on antidiabetes. Key words: Type 2 diabetes mellitus; Gastric bypass; Insulin resistance