New Billiopancreatic Diversion Surgery Decreases Blood Glucose Levels In GK Rats

【AIM】To observe whether New Billiopancreatic diversion (NBPD) surgery and Duodenal-jejunal bypass (DJB) surgery decrease blood glucose levels in Goto-Kakizaki (GK) rats .To investigate the effect of bile and pancreatic juice and to explore possible mechanisms involved.【METHODS】Twenty-four male GK rats were randomized into three groups: the first group undergoing DJB surgery (DJB surgery group), the second group undergoing NBPD surgery (NBPD surgery group) and the last group undergoing a sham operation (sham operation group). Body weight, fasting plasma glucose (FPG), oral glucose tolerance (OGTT), free fatty acid (FFA), plasma gastric inhibitory polypeptide (GIP) level and plasma levels of insulin and glucagon-like peptide-1 level (GLP-1) were determined.【RESULTS】There were no differences in body weight, FFA, plasma GIP level, plasma GLP-1 level and plasma levels of insulin among three groups before surgery. One week after the surgery, body weight of DJB-treated and NBPD-treated rats had markedly decreased and got better oral glucose tolerance compared with sham operation groups. There were no significant differences in plasma GIP, GLP-1 levels among three groups, FFA and INS were decreased in DJB surgery group and NBPD surgery group. Plasma INS level was extremely raised in sham operation group 8 weeks after surgery. There were no significant differences in FFA, plasma GIP level, plasma GLP-1 level in sham operation group pre-operations contrast post-operations.【CONCLUSION】Both DJB surgery and NBPD surgery can significantly improve carbohydrate tolerance in non-obese rats with type 2 diabetes, and the effect of DJB-treated was better than NBPD-treated. The duodenal-proximal jejunal exclusion and the division of bile and pancreatic juice may improve the carbohydrate tolerance after the gastrointestinal surgery. NBPD improve the carbohydrate tolerance possibly by reduce the lipoid absorption, improve function of B cell and elevate the insulin sensitivity.