Clinical observation of gastric bypass in treatment of patients with type 2 diabetes mellitus

Abstract

Objective Gastric bypass(GBP), especially Roux-en-Y, is the main surgical procedure in patients with type 2 diabetes mellitus(T2DM). The present study focused on the evaluation of efficiency of Roux-en-Y Gastric bypass(RY-GBP) in T2DM patients. Methods Two hundred and fourteen patients with T2DM were operated according to the RY-GBP procedures, and gastric pouch as well as Roux limb were selected respectively by the BMI and insulin resistance. Blood glucose alterations(OGTT), Fins, FC-P, HbAlc, BMI, related complications and anti-sugar drugs were observed at four phases(before the operation, 3 months, 6 months, 12 months after operation). Results Among 214 T2DM patients, 51( 23.8%) were cured at the time of discharge without anti-sugar drugs, the same with the others: 78(36.4%) at three months, 21(9.8%) between 3-6 months, 18(8.4%) during 6-12 months. Although 46 patients(21.5%) were still to be given anti-sugar drugs, dosage decreased markedly and follow-up of them were ongoing. The chemical data and other indexes were recovered in total 168 patients, which indicated healing rate 78.5%(168/214). There was no death in our group except some complications, such as anastomotic stoma bleeding (2 cases), anastomotic stoma ulcer(7 cases), gastroplegia(21 cases), nutritional disturbance (3 cases), anaemia(8 cases), which were relieved with symptomatic treatment. Especially, patients with malnutrition or anaemia were non-obese(BMI < 24 kg/m2). Conclusion RY-GBP present wonderful therapeutic effects in obese patients and non-obese patients, especially the mechanism in non-obese patients is worth to be further investigated. Key words: Type 2 diabetes mellitus; Gastric bypass; Treatment; Roux-en-Y