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Influence of gastrectomy for stomach cancer on type 2 diabetes mellitus for patients with a body mass index less than 30 kg/m2 / 대한외과학회지
Article in En | WPRIM | ID: wpr-207562
Responsible library: WPRO
ABSTRACT

PURPOSE:

The impressive effect of LRYGBP on mildly obese patients (30 kg/m2 < BMI < 35 kg/m2) with T2DM raises the argument for lowering the threshold for surgical intervention to non-obesity (BMI < 30 kg/m2). The goal of this study was to evaluate the effect of gastrectomy on non-obese patients with T2DM and what preoperative clinical factors are associated with postoperative long term improvement.

METHODS:

In this retrospective review, we analyzed the change in diabetic status in 75 patients with gastric cancer undergoing three different gastrectomies in a single institution from June 1996 to September 2009. Pre- and postoperative fasting blood glucose, serum hemoglobin A1c and diabetic medication requirements were compared. The demographic data and other biochemical markers were also collected.

RESULTS:

At an average follow-up of 35.0 +/- 25.9 months, we collected the data of 75 patients and evaluated the change of diabetes status. There was no resolution of diabetes in Billroth-I (B-I) group, and 45.2% of patients improved whereas the resolution rate of Billroth-II (B-II) and RY group was 22.2% and 23.5% and 85.2% and 88.2%, respectively. The improvement rate of diabetes mellitus (DM) status was 7.46 times higher in B-II than in B-I patients. The method of reconstruction is the most powerful factor and severity and duration of diabetes showed significant clinical factors for the improvement of the disease after surgery.

CONCLUSION:

According to these results, foregut-bypass procedure may improve the type 2 DM better than can be explained by the effect of weight loss only. Diabetes remission is significantly higher in those with duration of diabetes less than 5 years.
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Full text: 1 Database: WPRIM Main subject: Stomach / Stomach Neoplasms / Blood Glucose / Hemoglobins / Biomarkers / Gastric Bypass / Weight Loss / Body Mass Index / Retrospective Studies / Follow-Up Studies Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Journal of the Korean Surgical Society Year: 2012 Document type: Article
Full text: 1 Database: WPRIM Main subject: Stomach / Stomach Neoplasms / Blood Glucose / Hemoglobins / Biomarkers / Gastric Bypass / Weight Loss / Body Mass Index / Retrospective Studies / Follow-Up Studies Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Journal of the Korean Surgical Society Year: 2012 Document type: Article