Therapeutic Effect Observation Of Roux-en-y Gastric Bypass For Type2Diabetes And Research For The Factors Of Prognosis

Type2diabetes has always been to given medical treatment first, the therapeutic mechanism more focused on some link of its pathological physiology change, including diet and exercise, drug control, insulin injections, etc. With the the gradual development of weight loss and metabolic surgery and its good effect for type2diabetes, many of the clinical doctors use the gastrointestinal surgery to the patients with morbidly obese (BMI>35kg/m2) and type2diabetes. In many ways of operation, Roux-en-Y Gastric Bypass is the most popular ways to perform operations in now. There are reports show that the cure rate of the Roux-en-Y Gastric Bypass on the type2diabetes in obese more than80%,and the effective rate is90%.But there are lack of the clinical data which the Roux-en-Y Gastric Bypass for the non-morbidly obese type2diabetes from many center and large sample.Purpose:This sbuject to a group of patients with type2diabetes for research object, by looking at patients who receive Roux-en-Y Gastric Bypass flow of postoperative diabetes outcome and recovery, with the purpose to clear whether RYGB has the treatment function to all T2DM patients. And through comparing the different therapeutic level of patients basic material, to get the factors that influence the affecting outcome, in order to clear what characteristics the patients have can through the surgery to get a bigger profit.Methods:Sorting and collect from June2010to July2011period30cases type2diabetes RYGB surgery patients in our hospitle and cooperative unit for do Roux-en-Y Gastric Bypass. To detailed record patients preoperative history materials,and followed-up in nine months, record the changes of the observation index such as FBG,2hBG, BMI, c-peptide. Using statistical software analysiseach observation index preoperative and after surgery. And according to the recovery situation to group, comparing the patients’basic material preoperative at different level of effect.Result:In this topic93%(28/30) of patients achieved varying levels of diabetes recovery,60%(18/30) of patients to the heal standard. Patients with the characteristics of low age, duration relatively short, BMI, higher c-peptide obtained a better effect.The postoperative complications with gastric peristalsis function obstacle mainly. In the cases6(20%) patients occurred stomach slumped,and recovered after therapy in short term.2cases occurred diarrhea, recovered in six monthes. All patients were followed up for nine months without long-term complications.Conclusion:1、 For most of the type2diabetes whose medical history less than15years, RYGB has a good curative effect, including the non-obese type2diabetes.2、 Patients with the characteristics of low age, duration relatively short, BMI, higher c-peptide could obtain a better effect.3、 The complications of the patients with type2diabetes received the RYGB are mainly by gastric peristalsis function obstacle, which had a higher incidence. Other recent complications related to the operation with a low incidence.