Roux-en-Y Gastric Bypass In Treatment Of Obese Type2Diabetes

Objective:This study aimed to compare the effect of laparoscopic Roux-en-Y gastric bypass (LRYGB) on type2diabetes mellitus (T2DM) in obese patients with medical therapy, explore mechanisms of RYGB and observe the postoperative complications in order to evaluate the security.Methods:15patients accepted LRYGBP and12patients accepted medical therapy. Body mass index (BMI) of them was above28kg/m2. We compared changes of BMI, fasting plasma glucose(FPG),2-h oral liquid glucose challenge test (OGTT), glycated hemoglobin(HbA1c) and C peptide level in both groups. In LRYGB group, we also measured gastrointestinal hormone (GLP-1and Ghrelin). Then we analyzed the efficacy of RYGB on T2DM and studied the mechanisms. Adverse events were recorded to assess the security of RYGB.Results:All of the15patients received LRYGB successfully. They were followed up for12months. After12months,13cases (86.7%) of them reached the diabetic cure standard and plasma glucose of2cases (13.3%) was controlled. In control group,8cases (66.7%) were controlled in plasma glucose,4cases (33.3%) were improved. Improvements of RYGB in BMI, plasma glucose, HbAlc and C peptide level were more significant than medical group (P<0.05). Gastrointestinal hormones changed significantly (P<0.05). The incidence of complications was low after surgery during one year.Conclusion:LRYGB is more effective than traditional medical therapy in obese patients with T2DM. Gastrointestinal hormones are various and mechanisms of RYGB should be researched further. Short-term complications occurred after operation with low proportion, there are certain securities.