PP.05.01] THE EFFECT OF A SIDE-TO-SIDE JEJUNOILEAL ANASTOMOSIS ON GLYCEMIC CONTROL. EXPERIMENTAL STUDY IN A NON-OBESE DIABETIC RAT MODEL

Abstract

Objective: Bariatric procedures, such as the gastric bypass and the biliopancreatic diversion, have evidenced to induce long term remission of type 2 diabetes mellitus (T2DM) in morbidly obese patients. In recent years, new procedures are developed. We have previously published a novel food-diverting operation, sleeve gastrectomy plus side-to-side jejunoileal anastomosis (SJA). The positive results obtained from this procedure in reducing the excess weight, but most importantly in controlling the co-morbid conditions particularly T2DM in morbidly obese patients, led us to study the feasibility of SJA without sleeve gastrectomy to control T2DM, in non-obese diabetic Goto-Kakizaki (GK) rats. Design and method: Seventeen 14-week-old male GK rats were divided into 3 groups: SJA bypassing 60% of the small bowel length, sham-operated jejunoileal bypass (Sham group) and control animals. Rats were observed for 10 weeks after surgery. The fasting blood glucose (FBG), serum cholesterol and triglycerides levels were measured and oral glucose tolerance test (OGTT), were performed. Results: Animals in SJA group experienced significant loss of weight from the first and up to 4 weeks after the operation (% Total Weight Loss 7.2%). The weight of the rats in this group was stabilized thereafter, but remained reduced comparing with the pre-operative values (p < 0.001). There was no significant weight loss in the 2 other groups. Compared with sham-operated rats and controls, the fasting glucose levels were significantly lower in the SJA group from the 1st postoperative week and continued to be within normal range up to the 10th week. Prior to the procedures, no difference in OGTT was found among all groups. However, all rats in SJA group showed a significant improvement in OGTT, compared with sham-operated and control groups, at 3 and 8 weeks postoperatively. Serum cholesterol and triglycerides levels had no difference prior to surgery among all experimental groups. No significant differences in those parameters were observed following SJA or Sham procedures. Conclusions: A simple SJA, diverting the food and biliopancreatic secretion to the distal small bowel, was able to normalize both FBG levels and OGTT in a non-obese diabetic rat model.