A prospective controlled study of gastric bypass surgery for the type 2 diabetes patients with or without obesity

Ke Gong, MD, Nengwei Zhang, MD, Dexiao Du, MD, Bin Zhu, MD, Dongbo Lian, MD, Zhen Zhang, MD. Shijitan Hospital, Capital Medical University, Beijing, China.

Background Gastric bypass surgery is an effective surgical procedure for the type 2 diabetes patients with obesity. However, the application of gastric bypass surgery for no obese type 2 diabetes patients is still controversial in China. Objectives To evaluate the procedure of gastric bypass for the type 2 diabetes patients without obesity.

Methods: Twenty-four patients suffering from type 2 diabetes were selected to undergo laparoscopic gastric bypass surgery and were enrolled at Beijing Shijitan Hospital, Capital Medical University. Based on BMI before surgery, they were divided into two groups: no obesity group (BMI<30kg/m2) (group1) and obesity group (BMI>30 kg/m2) (group2). Before and after surgery, the serum glucose, C-peptide and insulin were measured and the results were compared.

Results It took two years spanning April 2011 to April 2013 to complete the study. 24 patients suffered from type 2 diabetes underwent laparoscopic gastric bypass surgery successfully ( a mean age of 41 years), 12 were male and 12 were female . The mean BMI was 29.96±5.36 kg/m2 of 24patients before surgery. There were 12 patients in group 1 ( a mean BMI of 25.71±2.18 kg/m2) and 12 patients in group 2 (a mean BMI of 34.33±3.85 kg/m2). There were no significant difference in the age and sex in two groups (P>0.05). The mean fasting blood glucose of all patients was 9.86±3.20mmol/L (normal 3.90~6.10 mmol/L) before surgery and was significantly decreased after surgery (P<0.001). The 0.5hr-, 1hr-, 2hr-, 3hr-postprandail blood glucose were also significantly decreased respectively (P<0.001) in all patients after surgery. The mean fasting serum C-peptide of all patients was 3.37±1.45ng/ml (normal 3.90~6.10 mmol/L) before surgery. The mean fasting, 0.5hr-, 1hr-postprandail serum C-peptide of all patients were significantly decreased after surgery compared with those before surgery (P<0.001). Compared before and after surgery, there were no statistical difference in the levels of fasting, 0.5hr-, 1hr-, 2hr-, 3hr-postprandail serum insulin respectively in all patients (P>0.05). By contrast, there were no significant difference statistically in the changes of serum glucose, C-peptide and insulin in two groups after surgery (P>0.05).

Conclusions This research shows that gastric bypass procedure is effective to treat the patients who suffered from type 2 diabetes without obesity and can be applied widely in China.
Keywords Gastric bypass surgery; Type 2 diabetes; Obesity

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