The Research Of Curative Effect Of Different Gastric Bypass Operation To Non-obese Type 2 Diabetes

【Objective】To evaluate the effect of diabetic control after small intestine exclusion surgery in Goto-Kakizaki (GK) rat with type II diabetes mellitus,and to find which is the best sect in the small intestinal.【Methods】60 GK type 2 diabetic rats underwent duodenal bypass (Group A, n=12) creating a shortcut for ingested nutrients with bypassing duodenum alone, or duodenal-jejunal bypass (Group B, n=12), a stomach-preserving RYGB excluding duodenum and proximal jejunum, or duodenum and 1/3 jejunum exclusion (Group C, n=12), or 1/2 small intestine exclusion (Group D, n=12) creating a shortcut for ingested nutrients with bypassing duodenum and a part of jejunum. Controls were pair-fed (PF) sham-operated and untreated GK rats (Group S, n=12). Rats were observed for 24 weeks after surgery. Fasting blood glucose (FBG) level,2h blood glucose , food-intake and weight was determined on a Surestep plus blood glucose meter (Lifescan) at 0, 1, 3, 6, 12, 24 week. Hemoglobin A1c (HbA1c) level was measured at 0, 12, 24 week.【Results】1. Blood-glucose and HbA1c Blood glucose and HbA1c of Group S have no difference after operation (P>0.05) , and Blood glucose and HbA1c decreased after surgery in all the operative groups through the entire follow-up period (P<0.05).2. Food-intake and Weight Food-intake and weight have no difference before and the 24th week after operation between each groups.3. Complication after operation Complication after operation include cacotrophy and diarrhoea, complication of Group D is serious furthest of all, mortality of Group A and S is 0%, mortality of Group B,C and D is 8.3%,25% and 33.3% respectively.【Conclusion】1. Duodenal and the top of jejunal(8cm) are best sect of the small intestine for diabetic control.2. Duodenal-jejunal bypass is an ideal surgery for diabetic control with least complication and mortality.