ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the one year effect of modified Roux-en-Y gastric bypass (RYGP) in the treatment of non-obese type 2 diabetes and to investigate the reasonable indications for surgery.</p><p><b>METHODS</b>Totally 72 patients diagnosed as type 2 diabetes underwent RYGP from May 2009 to June 2010. There were 45 male and 27 female patients, with an average age of (47 ± 10) years. Preoperative body mass index (BMI) of the patients was 18.69 to 31.22 kg/m(2), average (26 ± 4) kg/m(2). The follow-up data included fasting plasma glucose (FPG), 2 h plasma glucose after oral glucose challenge (2hPG), weight, BMI and medication usage in 1, 3, 6 and 12 months postoperative; hemoglobin A1c (HbA1c), fasting C-peptide (C-P), fasting serum insulin (Fins) and homeostasis model assessment of insulin resistance index (HOMA-IR) in 6 and 12 months postoperative, respectively.</p><p><b>RESULTS</b>Compared with the preoperative, FPG, 2hPG, weight and BMI in 1, 3, 6 and 12 months after surgery were improved (t = 7.014 to 10.254, P = 0.000), while HbA1c, C-P and HOMA-IR in 6 and 12 months after surgery were improved (t = 1.782 to 7.789, P = 0.000 to 0.103) and there was no significant difference in Fins (P > 0.05). The rates of complete remission in 1, 3, 6 and 12 months after surgery were gradually improved to 22.2%, 27.8%, 36.1% and 60.6%, respectively, and the rate of remission in 1 year was 94.3%. The complete remission of 1 year after surgery was associated with normal C-P, insulin antibody and oral antidiabetic drugs (χ(2) = 11.730, P = 0.003; χ(2) = 7.131, P = 0.028;χ(2) = 6.149, P = 0.046).</p><p><b>CONCLUSIONS</b>Modified RYGP is safely and effectively in the treatment of no-obese type 2 diabetes patients. The function of islet cells is significantly improved after operation. Especially for the patients of whom C-P is normal, insulin antibody is negative before surgery, the rate of complete remission after 1 year is better.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Blood Glucose , Metabolism , Body Mass Index , C-Peptide , Metabolism , Diabetes Mellitus, Type 2 , General Surgery , Follow-Up Studies , Gastric Bypass , Methods , Glycated Hemoglobin , Metabolism , Insulin , Blood , Insulin Resistance , Obesity , Weight LossABSTRACT
To compare the sampling errors from cluster or unequal probability sampling designs and to adopt the unequal probability sampling method to be used for death surveillance.Taking 107 areas from the county level in Shaanxi province as the sampling frame,a set of samples are drawn by equal probability cluster sampling and unequal probability designs methodologies.Sampling error and effect of each design are estimated according to their complex sample plans.Both the sampling errors depend on the sampling plan and the errors of equal probability in stratified cluster sampling appeares to be less than simple cluster sampling.The design effects of unequal probability stratified cluster sampling,such as πPS design,are slightly lower than those of equal probability stratified cluster sampling,but the unequal probability stratified cluster sampling can cover a wider scope of monitoring population.Conclusions:Results from the analysis of sampling data can not be conducted without consideration of the sampling plan when the sampling frame is finite and a given sampling plan and parameters,such as sampling proportion and population weights,are assigned in advance.Unequal probability cluster sampling designs seems to be more appropriate in selecting the national death surveillance sites since more available monitoring data can be obtained and having more weight in estimating the mortality for the whole province or the municipality to be selected.