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Gastric bypass procedure for type 2 diabetes patients with BMI <28 kg/m2

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Abstract

Objectives

To evaluate the Roux-en-Y gastric bypass (GBP) procedure for patients suffering from type 2 diabetes mellitus (T2DM) with body mass index (BMI) <28 kg/m2.

Methods

Thirty-one patients suffering from T2DM were selected to undergo laparoscopic Roux-en-Y gastric bypass surgery and were enrolled at Beijing Shijitan Hospital between November 2012 and December 2014. The fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), C-peptide, fasting insulin (FINS) and glucagon-like peptide-1 (GLP-1) of all patients were measured before and at 1, 3, 6 months after surgery. The results were compared and analyzed.

Results

Thirty-one patients suffering from T2DM successfully underwent GBP surgery (a mean age of 46 years), 14 were male and 17 were female. Among them, 7 patients had hypertriglyceridemia (HTG). The patients were followed up for 6 months. No major complications were found. The average BMI was 26.5 ± 1.4 kg/m2 before surgery. The average levels of FPG, HbA1c, C-peptide, FINS of all patients were statistically decreased after surgery, respectively, compared to those before surgery (P < 0.05). However, the mean GLP-1 of all patients was statistically increased after surgery compared to that before surgery (P < 0.05). At 6 months after surgery, 22 patients (71 %) achieved complete remission of T2DM with HbA1c < 6.5 %, 7 patients (23 %) gained partial remission of T2DM with 6.5 % ≤ HbA1c < 7.0 % and 2 patients (6 %) experienced no remission of T2DM. The mean serum triglyceride of 31 patients was statistically decreased after surgery compared to that before surgery (P < 0.05).

Conclusions

This research shows that the GBP procedure is safe and effective for T2DM patients with BMI <28 kg/m2, and the condition of patients with HTG was greatly improved. However, further studies with larger samples and long-term follow-up are needed.

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Acknowledgments

Authors thank Dr. Bin Zheng at the Department of Surgery, University of Alberta for reviewing the paper and provide critical comments during manuscript preparation.

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    Authors and Affiliations

    1. Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China

      Ke Gong, Kai Li, Nengwei Zhang, Bin Zhu, Dexiao Du, Dongdong Zhang, Zhen Zhang & Jirun Peng

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    1. Ke Gong
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    2. Kai Li
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    Correspondence to Ke Gong or Nengwei Zhang.

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    Ke Gong, Kai Li, Nengwei Zhang, Bin Zhu, Dexiao Du, Dongdong Zhang, Zhen Zhang and Jirun Peng have no conflicts of interest or financial ties to disclose.

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    Ke Gong and Kai Li have contributed equally to this study and share first authorship.

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    Gong, K., Li, K., Zhang, N. et al. Gastric bypass procedure for type 2 diabetes patients with BMI <28 kg/m2 . Surg Endosc 31, 1172–1179 (2017). https://doi.org/10.1007/s00464-016-5087-3

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