Analysis of 3-year effect of gastric bypass on type 2 diabetes mellitus

doi:10.3877/cma.j.issn.1674-6899.2018.05.003

Abstract

Abstract:

Objective

To investigate the curative effect of laparoscopic gastric bypass (LGBP) on type 2 diabetes mellitus(T2DM) for 3 years in China.

Methods

Clinical data of 58 patients with T2DM undergoing LGBP from Apr.2012 to Mar. 2014 was studied retrospectively. Weight, blood glucose, blood lipids and surgical complications were observed in 3, 6, 9, 12, 24 and 36 months after operation, and compared by t-test or rank sum test.

Results

Among 58 cases of T2DM patients were successfully completed LGBP without conversion to laparotomy. Weight reached the lowest level at 9 months after LGBP. The average weight were lower respectively at 12, 24 and 36 months postoperatively compared with preoperative (P< 0.05). The complete remission rate of T2DM were 72.5%, 71.4% and 52.9% respectively at 12, 24 and 36 months after operation. Fasting plasma glucose(FPG)decreased to a minimum level at 6 months after operation. Hemoglobin A1c (HbA1c) fell to a minimum level 9 months postoperatively. FPG and HbA1c were lower respectively at 12, 24 and 36 months postoperatively compared with preoperative (P< 0.05). Triglycerides, high density lipoprotein and low density lipoprotein were significantly improved three years after LGBP compared with preoperative (P< 0.05). There were 1 case of gastrointestinal anastomotic stenosis and 1 case of Y anastomotic bleeding in small intestine after LGBP.

Conclusions

LGBP is safe and effective in the mid-term effect of T2DM in China.

Key words: Laparoscopic, Gastric bypass, Type 2, Diabetes mellitus, Bariatric surgery

Wenmao Yan, Changyou Jing, Youguo Li, Jun Xu, Zhiqiang Zhong, Ying Xing, Yi Lin, Ming Yan, Rixing Bai. Analysis of 3-year effect of gastric bypass on type 2 diabetes mellitus[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(05): 268-273.

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References 35

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时间	例数	FPG(mmol/L， ±s)	HbAlc(%, ±s)	HbA1c≤6.5%[例(%)]
术前	58	7.73±2.63	8.5±1.7	－
术后3个月	48	6.58±1.40^a	6.3±1.0^a	－
术后6个月	45	6.12±1.11^a	6.2±1.0^a	－
术后9个月	41	6.41±1.42^a	6.0±1.5^a	－
术后12个月	40	6.42±2.11^a	6.1±1.1^a	29(72.5)^b
术后24个月	35	6.49±1.49^a	6.3±1.1^a	25(71.4) ^b
术后36个月	34	6.91±1.53^a	6.7±1.2^a	18(52.9)^b

时间	例数	FPG(mmol/L， ±s)	HbAlc(%, ±s)	HbA1c≤6.5%[例(%)]
术前	58	7.73±2.63	8.5±1.7	－
术后3个月	48	6.58±1.40^a	6.3±1.0^a	－
术后6个月	45	6.12±1.11^a	6.2±1.0^a	－
术后9个月	41	6.41±1.42^a	6.0±1.5^a	－
术后12个月	40	6.42±2.11^a	6.1±1.1^a	29(72.5)^b
术后24个月	35	6.49±1.49^a	6.3±1.1^a	25(71.4) ^b
术后36个月	34	6.91±1.53^a	6.7±1.2^a	18(52.9)^b

时间	例数	未使用药物	使用药物			P值
时间	例数	未使用药物	口服降血糖药	胰岛素	口服降血糖药＋胰岛素	P值
术前	58	－	33(56.9)	11(19.0)	14(24.0)	－
术后12个月	56	39(69.6)	5(8.9)	12(21.4)	0(0.0)	< 0.001
术后24个月	52	41(78.8)	5(9.6)	4(7.7)	2(3.8)	< 0.001
术后36个月	40	30(75.0)	5(12.5)	4(10.0)	1(2.5)	< 0.001

时间	例数	未使用药物	使用药物			P值
时间	例数	未使用药物	口服降血糖药	胰岛素	口服降血糖药＋胰岛素	P值
术前	58	－	33(56.9)	11(19.0)	14(24.0)	－
术后12个月	56	39(69.6)	5(8.9)	12(21.4)	0(0.0)	< 0.001
术后24个月	52	41(78.8)	5(9.6)	4(7.7)	2(3.8)	< 0.001
术后36个月	40	30(75.0)	5(12.5)	4(10.0)	1(2.5)	< 0.001

时间	例数	TG	TCHO	HDL	LDL
术前	58	2.30±2.11	4.79±0.92	1.14±0.23	2.76±0.77
术后3个月	46	1.24±0.68^a	4.38±0.80^a	1.25±0.31^a	2.59±0.62^a
术后6个月	43	1.09±0.61^a	4.15±0.68^a	1.47±0.62^a	2.25±0.57^a
术后9个月	39	1.37±0.82^a	4.35±0.81^a	1.43±0.62^a	2.48±0.69^a
术后12个月	40	1.07±0.54^a	4.25±0.80^a	1.43±0.33^a	2.39±0.65^a
术后24个月	34	1.23±0.90^a	4.47±0.79	1.47±0.32^a	2.60±0.68
术后36个月	28	1.22±0.68^a	4.57±0.91	1.47±0.42^a	2.71±0.88^a

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