One Year Follow-up Research After Gastric By Pass Operation On Type2Diabetes Patients

Background Right now, the mechanism of Diabetes is not all clearly and lacking of the better methods to improve the insulin function and to prevent the complications of Diabetes is one most important reason of the high incidence and fatality rate of Diabetes. Always the doctor used medical therapy in the clinic to cure Diabetes. But we can find some results from the resently years that Gastric Bypass, as an effective operation to cure obesity, it also can cure Type2Diabetes. At present, the reports of using Grastric bypass operation to cure T2DM are limitied to clinical postoperation retrospective study articles of forein obesity patients, moreover, there is less report about the GBP on T2DM patients in china.Objective observe the effect of gastric bypass (GBP) on T2DM patients, we investigated the change of glucose tolerance and insulin tolerance as well as lipid metabolism on T2DM patients after GBP surgery during the follow-up.Methods From July2010to March2012,61T2DM patients undergoing GBP were recruited and divided into before GBP、1month after GBP、3monthes after GBP、6monthes after GBP、12monthes after GBP group. Testing oral glucose tolerance test, insulin release test, C peptide release test, HbAlC,, waist circumference (WC), hip circumference, and calculating BMI, WHR, HOMA-IR, HOMA-β,ISI, Δl30/ΔG30,AUCg, AUCIns at pre-operation and at month after GBP、3month after GBP、6month after GBP、12month after GBP.Results①During the one year follow-up, among all the patients, total remission of T2DM is74%, which is77.78%in overweight/obesity patients and66.67%in normal weight patients.②BMI dropped significantly in overweight/obes--ity patients and was below to24kg/m2in82.5%of over weight/obesity patients, which was no change in normal weight patients.③Comparing with the level of FGP and2hGP at pre-operation, FGP and2hGP dropped significantly after GBP one year.④Comparing with the level of insulin AUC at pre-operation, insulin AUC dropped significantly after GBP one month and three month, but insulin AUC increased significantly after GBP six month and tweelve month.⑤Comparing with the level of insulin secretion at pre-operation, ΔI30/ΔG30increased significantly at one years post operation.⑥Comparing with the level of HOMA-IR at pre-operation, HOMA-IR decreased obviously at one years post operation.⑦Comparing with the level of TG at pre-operation, TG dropped significantly after GBP one month and six month. Comparing with the level of CH at pre-operation, CH dropped significantly after GBP three month、six month and twelve month. Comparing with the level of HDL-Dat pre-operation, HDL-D dropped significantly after GBP one month and three month, but HDL-D increased significantly after GBP six month, at tweelve month post operation as same as pre-operation. Comparing with the level of LDL-D at pre-operation, LDL-D dropped significantly after GBP one year.⑧Comparing with the level of WC and WHR at pre-operation, WC and WHR dropped significantly after GBP one year. Comparing with the level of HC at pre-operation, HC dropped significantly after GBP three month and six month.⑨During the one years follow-up, among all the patients, total remission of MS is77.27%, which is75%in overweight/obesity patients.Conclusions The follow-up time has negative correlation with FGP and2hGP as well as HbAlc. Comparing with the level of insulin AUC at pre-operation, insulin AUC dropped significantly after GBP one month and three month, it means short-term effet is insulin resistance, but insulin AUC increased significantly after GBP six month and tweelve month, it illustrates forward insulin hypersecretion and insulin get better function.Gastic Bypass has positive therapeutical effet on type2Diabetes and MS, and should be further studied with large sample size in future.