Abstract

Recent studies suggest the possibility of the stomach playing a role in diabetes remission after bariatric surgery. In this study, we investigated whether bypassing the stomach alleviates diabetes in diabetic rodent model. Eighteen moderately obese and diabetic Sprague-Dawley rats were randomly assigned to Esophagoduodenostomy with or without gastric preservation (EDG and EDNG/total gastrectomy, respectively), and SHAM groups. Bodyweight, food intake, fasting glucose level, oral glucose tolerance test result (OGTT), and hormone levels (insulin, glucagon-like peptide-1, ghrelin, gastrin and glucagon) were measured preoperative and postoperatively. Postoperatively, bodyweight and food intake did not differ significantly between the EDG and EDNG groups. Postoperative fasting blood glucose and OGTT results declined significantly in the EDG and EDNG group when compared with the respective preoperative levels. Postoperative glucose control improvements in EDNG group was significantly inferior when compared to EDG. Compared preoperatively, postoperative plasma ghrelin and gastrin levels declined significantly in EDNG group. Preoperative and postoperative plasma GLP-1 level did not differ significantly among all the groups. Postoperatively, EDG group had significantly higher insulin and lower glucagon levels when compared with SHAM. In conclusion, bypassing and preserving the stomach resulted in superior glucose control improvements than total gastrectomy.

Highlights

  • The anti-diabetic effect of RYGB can be elucidated through foregut and hindgut theories[4]

  • Some studies reported that total gastrectomy resulted in impaired glucose control[12,13,14,15,16], whereas others reported that total gastrectomy resulted in diabetes remission in gastric cancer and type-2 diabetes mellitus (T2DM) patients[17,18,19]

  • In this study, using T2DM-induced Sprague-Dawley (SD) rodent model, we investigate the anti-diabetic effect of bypassing the stomach, with either preserved gastric or total gastrectomy (Fig. 1)

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Summary

Introduction

The anti-diabetic effect of RYGB can be elucidated through foregut (proximal gut exclusion) and hindgut (rapid nutrients flow to the distal gut) theories[4]. Some studies reported that total gastrectomy resulted in impaired glucose control[12,13,14,15,16], whereas others reported that total gastrectomy resulted in diabetes remission in gastric cancer and type-2 diabetes mellitus (T2DM) patients[17,18,19]. This experiment aimed to further investigate the potential role of the stomach on glucose control. In this study, using T2DM-induced Sprague-Dawley (SD) rodent model, we investigate the anti-diabetic effect of bypassing the stomach (without foregut exclusion), with either preserved gastric (esophagoduodenostomy with gastric preservation, EDG) or total gastrectomy (esophagoduodenostomy without gastric preservation, EDNG) (Fig. 1)

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