Study Of Therapeutic Efficacy Of Combined Treatment Of Medium-chain Triglycerides And Laparoscopic Roux-en-Y Gastric Bypass On Type 2 Diabetes Mellitus

Part ? Clinical observation of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitusObjective:To analyze the early curative effectiveness of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus;Compare the clinical date of different levels of type 2 diabetes mellitus remission to identify practical clinical predictors of type 2 diabetes mellitus for laparoscopic Roux-en-Y gastric bypass patients.Methods:We make a a retrospective analysis of the clinical date of type 2 diabetes mellitus for laparoscopic Roux-en-Y gastric bypass at Nan Jing Drum Tower hospital from December 2012 to March 2015.35 type 2 diabetes mellitus patients who had underwent laparoscopic Roux-en-Y gastric bypass were included in our research, we analyze the clinical date before surgery and 1 month,3 months,6 months and 1 year after surgery to assess the early curative effectiveness of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus. And we compare the clinical date of different levels of type 2 diabetes mellitus to identify the clinical date before surgery which can predict the curative effectiveness of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus.Results:According to the guideline of Chinese obesity and type 2 diabetes mellitus 2014,22 patients got complete remission(62.9%),6 patients got partial remission (17.1%),6 patients got improvement (17.1%),1 patient had no improvement(2.9%), so we can think that the early curative effectiveness of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus is excellent. We compare the clinical date of patients of complete remission, partial remission and improvement. According to the results we can conclude that the patients with higher body mass index, higher fasting C peptide and shorter duration of type 2 diabetes mellitus can achieve better curative effectiveness.Conclusions:The early curative effectiveness of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus is excellent. The patients with higher body mass index, higher fasting C peptide and shorter duration of type 2 diabetes mellitus can get better curative effectiveness.Part 2 Study of therapeutic efficacy of combine medium-chain triglycerides with Laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitusObjective:Compare the difference of curative effectiveness between combined medium-chain triglycerides with laparoscopic Roux-en-Y gastric bypass and simple laparoscopic Roux-en-Y gastric bypass. Assess the effect of medium-chain triglycerides in Bariatric surgery.Methods:16 type 2 diabetes mellitus patients were randomly divided into experimental group and control group. There were 8 patients in each group. We added medium-chain triglycerides into the dietary of experimental group for 8 weeks and the control group received normal dietary after Bariatric surgery. We analyzed the clinical date of these two groups before surgery,1 month,3 months, and 6 months after surgery respectively to assess the effect of medium-chain triglycerides in Bariatric surgery.Results:There were no statistical differences in experimental group and control group on the clinical date of anthropometry and nutritional date. There were statistical differences of fasting plasma glucose, fasting insulin, fasting C-peptide and HOMA-IR and no statistical differences in 2-hour postprandial glucose and glycosylated hemoglobin.Conclusions:Compared with simple laparoscopic Roux-en-Y gastric bypass, combined medium-chain triglycerides with laparoscopic Roux-en-Y gastric bypass could achieve better curative effectiveness of insulin resistance and improved the therapeutic effect of Bariatric surgery on type 2 diabetes mellitus can get better curative effecticeness.