Duodenal Endoluminal Sleeve On Glucose Metabolism Improve Of Non-obese Type2Diabetic Rats

【Objective】Through establish the Duodenal endoluminal sleeve modle of non-obese T2DMrat, comparative the impact of the ELS group with the SO group on T2DM ratsmetabolize glucose levels and glucose metabolism-related hormones. Then explorethe hypoglycemic effect of ELS on non-obese T2DM rats and its possible mechanism.But also provide the clinical treatment of T2DM of new ideas, which has importantacademic and practical value.【Methods】Selection of24spontaneous male GK rats, with8-10weeks old, body weight220~280g.By randomly divided into surgery group (ELS, n=12) and sham-operatedgroup (SO, n=12). ELS group underwent the surgery of duodenal cannulaimplantation, SO group make the same incision and place match, and use the sameoperation time with the control groups. Fasting plasma glucose (FPG) levels of the2groups were observed before surgery (0weeks),1,3,6,12, and24week after surgery.Oral glucose tolerance test (OGTT) were made before surgery (0weeks),6and24weeks after surgery. Blood glucose versus time curve was depicted and glucosetolerance area under the curve (AUC) was calculated. Glucagon-like peptide-1(GLP-1) concentration levels were measured2hours after glucose load.【Results】1. Postoperative conditionsAll of the surgical procedures were successful, the3day after,we started givingsolid feed, postoperative1week, all rats were decrease in food intake, which one ofthe ELS group appeared diarrhea, all of them recovered after symptomatic treatment,and two rats of the ELS group ccurred catheter off after6weeks, which one of themdeath in the seventh week, SO animals were without complications and death.2. Fasting blood glucose (FPG) Compared with the preoperative, the rats off the ELS group had significantlydecrease (P <0.05), while the SO group didn’t change significantly (P>0.05).Compared with the the SO group, the FPG of the ELS group were significantlydecreased at all time points (P <0.05).3. Oral Glucose Tolerance Test（OGTT）Compared with the preoperative glucose tolerance curve with preoperative of theELS group after6and24weeks, the glucose tolerance curve (area under the curve,AUC was1877±341(mmol·min/L), and1689±241(mmol·min/L), were significantlylower than preoperative2079±224(mmol·min/L), and had the lower peakpostoperative glucose tolerance (P <0.05).The group of ELS glucose peak time from60min before surgery advance to30min, the6and24weeks of postoperative therewas no significant change in these indicators (P>0.05); The AUC of the ELS6and24weeks after surgery were significantly lower than the SO group (P <0.05), and eachindex group were no significant changes in the SO group (P>0.05)4. Glucagon-like Peptide-1（GLP-1）The GLP-1of ELS group on6weeks and24weeks, respectively were43.2±8.3(Pmol/L) and74.7±11.1(Pmol/L), significantly higher than preoperative14.3±2.6(Pmol/L)(P <0.05), and reached the maximum value after the first24weeks, whilethe SO group did not change significantly. Compared two groups by postoperativetime points compared, The GLP-1concentrations of ELS group was significantlyhigher than the SO group.【Conclusions】1. The ELS which as a new T2DM treatment, can effectively control bloodglucose levels and improve glucose tolerance.2. The mechanisms to improve glycemic by the ELS are multi-way, thecombined effects of multiple factors, which undigested food stimulate the terminalileum L cells promote gastrointestinal hormone GLP-1secretion, may play a key role.