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The Outcome of Modified Roux-en-Y Gastric Bypass Surgery on Glycemic Control in Type 2 Patients

Blood glucose showed significant decrease months after procedure…

Type 2 diabetes has become more common in today’s society. Currently, modified gastric bypass surgery is used to treat type 2 diabetes. This intervention has been utilized since the 1990s. The procedure reached 83% efficiency and currently the therapeutic mechanism is still uncertain.

The purpose of this study is to clarify the outcome and the mechanism of modified gastric bypass surgery on glucose metabolism. The study was designed as a retrospective study that analyzed glucagon-like peptide-1 (GLP-1), gastric inhibitory polypeptide (GIP), and blood glucose in patients with type 2 diabetes who underwent modified Roux-en-Y gastric bypass surgery. The study consisted of 50 patients from January 2006 to September 2014. Blood was drawn before surgery at 1 week and 1, 3, and 6 months after surgery. Lab values that were recorded were fasting blood glucose, 2-hour postprandial blood glucose, HbA1c, fasting glucagon-like peptide-1, 2-hour GLP-1, fasting GIP, and 2-hour GIP. The recorded data were expressed as the mean + SD.

The results showed that preoperative fasting blood glucose and 2-hour postprandial decreased at 1, 3, and 6 months after surgery (p<0.01). HBA1c decreased significantly at 3 and 6 months after surgery (p<0.05). Fasting GLP-1 and 2-hour GLP-1 values increased significantly at 1 week and 1, 3, and 6 months after surgery (p<0.01). Fasting GIP values were decreased significantly 1, 3, and 6 months after surgery (p<0.05) and 2-hour GIP values decreased significantly at 1 week and 1, 3, and 6 months after surgery (p<0.01). 2-hour GIP was significantly higher before surgery in comparison to fasting GIP (p<0.01). However, there was no difference noticed after the surgery.

To conclude, the present study demonstrated that after a modified Roux-en-Y gastric bypass surgery, patients exhibited decreased levels of fasting blood glucose and 2-hour postprandial blood glucose in comparison to the values taken before surgery.

Practice Pearls:

  • 2-hour postprandial blood glucose and fasting blood glucose were decreased significantly at 1, 3, and 6 months after surgery.
  • HbA1c values were reduced at 3 and 6 months after the surgery in comparison to the values taken before the surgery.
  • Modified Roux-en-Y gastric bypass surgery amends digestive tract reconstruction which leads to the improvement of glycemic control in type 2 diabetics.

Xiong SW, Cao J, Liu XM, Deng XM, Liu Z, Zhang FT. “Effect of Modified Roux-en-Y Gastric Bypass Surgery on GLP-1, GIP in Patients with Type 2 Diabetes Mellitus.” Gastroenterol Res Pract. 2015;2015:625196.