Clinical Observational Study Of Effect Of Laparoscopic Roux-en-Y Gastric Bypass Surgery On Diabetes Mellitus

[Objective] To evaluate the recent clinical efficacy and safety of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery, and to explore the possible mechanisms of the surgery on diabetes control.[Methods] The analysis was undertaken of 12 patients who received LRYGB from July 2004 to November 2009. Subjects were divided into 3 groups:type 2 diabetes with obesity (AOT2DM) group (6 patients), non-obese type 2 diabetes (NOT2DM) group (5 patients) and type 1 diabetes (T1DM) group (1 patients). During the 6-month follow-up period, we recorded the change of body mass index (BMI), percentage of excess weight loss (EWL%), fasting plasma glucose (FPG),2-hour postprandial blood glucose (2HPG), glycosylated hemoglobin (HbAlC), modification of diabetic treatment. The follow-up datas were analysed by statistical test.[Results] LRYGB was accomplished in 12 patients, no case was converted to open procedures. No complications occurred after 6 months of follow-up postoperatively in AOT2DM group and NOT2DM group, the same to T1DM group after 3 months of follow-up postoperatively. After 6 months of the surgery, resolution of diabetes was 83.3% and 80% in AOT2DM group and NOT2DM group, respectively; remission of diabetes was 100% in both two groups. In AOT2DM group and NOT2DM group, BMI, FPG,2HPG, HbAlC linearly decreased with time within 6 months of the surgery. From baseline to 6 months, there was no significant difference between the two groups in the clinical outcomes FPG,2HPG, HbAlC changing with time. From baseline to 6 months, there was significant difference between the two groups in the clinical outcomes BM (F= 11.751,P=0.008). In AOT2DM group, EWL% linearly increased with time within 6 months of the surgery. There was no significant difference between diabetes'resolution group and diabetes' improvement group in the clinical outcomes EWL%. In T1DM group, FPG was 12.6mmol/L and HbAlC was 14.8% after 1 month of surgery; FPG was 11.5mmol/L and HbAlC was 12.0% after 3 months of surgery.[Conclusions] LRYGB is a safe and effective treatment for type 2 diabetes mellitus. The mechanism of LRYGB for treating diabetes is still unclear. More large prospective randomed controlled studies are necessary.