Effects of subtotal gastrectomy and Roux-en-Y gastrojejunostomy on the clinical outcome of type 2 diabetes mellitus.

BACKGROUND

To investigate the effects of subtotal gastrectomy and Roux-en-Y gastrojejunostomy on the clinical outcome of patients with type 2 diabetes mellitus (T2DM).

METHODS

We performed retrospective analysis of 21 patients with T2DM operated due to stomach cancer and upper gastrointestinal tract ulcer between January 2001 and June 2008.

RESULTS

The body mass index (BMl) of all patients was <30 kg/m(2). The mean postoperative follow-up period was 26.6 mo (range, 6 mo-5 y). Subtotal gastrectomy and Roux-en-Y gastrojejunostomy remarkably lowered the levels of fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG), and glycated hemoglobin (HbA1c). Overall, 12 patients (57.1%) achieved adequate glycemic control (HbA1c < 7%) without antidiabetic medication and five patients (23.8%) showed good improvement. The total effectiveness rate of the surgery in T2DM patients was 81.0%.

CONCLUSION

Subtotal gastrectomy and Roux-en-Y gastrojejunostomy appear to be effective treatment modalities for controlling T2DM in patients with BMl <30 kg/m(2). However, more studies with long follow-up period and large number of patients are necessary to clarify the benefits of this procedure.