Clinical Research Of Laparoscopic Gastric Bypass Operation In Promoting The Type 2 Diabetes Mellitus

Objective:To evaluate the efficacy of laparoscopic gastric bypass operation in the treatment of obesity type 2 diabetes mellitus in the northwest region of Heilongjiang Province,and to explore its therapeutic mechanism.Methods:98 patients with type 2 diabetes mellitus complicated with obesity were selected between the periods of January 2014 to September 2017 from the first general surgery department of our hospital.Firstly,the levels of fasting blood glucose,1 hour and 2hours postprandial blood glucose,insulin,and C-peptide of all the patients were examined before operation;then,the laparoscopic gastric bypass operation was formulated based on individual cases;finally,the diet of all the patients were strictly monitored after operation.The body mass index(BMI,kg/m2),fasting blood sugar,insulin and C-peptide values were measured after 6 months follow-up,and the preoperative and postoperative examination data of patients were compared.Results:Follow-up results showed that there were no complications occurred in all 98patients with obesity type 2 diabetes mellitus after operation.Among them,90patients were confirmed to be cured and 8 patients were significantly improved after 6months of operation.Compared with the average BMI(49.15±1.52 kg/m~2)of patients before operation,the average BMI of all patients decreased significantly(27.67±0.89kg/m~2)by 6 months after operation,there was significant difference before and after operation(P<0.01);Compared with the average fasting blood glucose(12.19±2.10mmol/L),average fasting insulin(25.86±2.34?U/ml)and average fasting C-peptide(171.03±4.35 nmol/L)of all patients before operation,the values of average fasting blood glucose,average fasting insulin and fasting C-peptide decreased by 38.80%,22.04%and 50.27%respectively in 6 months after operation,the differences between before and after operation have statistical significance(P<0.01).Compared with the average fasting gastric inhibitory polypeptide,GIP(534.56±42.68 ng/L)and average postprandial GIP at 1 hour(1950.83±32.44 ng/L)of patients before operation,the average fasting GIP(339.87±12.26 ng/L)and average postprandial GIP at 1 hour(1155.58±34.58 ng/L)of all patients were significantly decreased by 6 months after operation,the differences have statistical significance(P<0.01).Conclusion:1.Laparoscopic gastric bypass operation is a safe and effective treatment method.2.Laparoscopic gastric bypass operation is effective for the treatment of obesity type 2 diabetes mellitus,which can prompt the rapid reduction of fasting blood sugar and plasma C-peptide protein,and improve the symptoms of patients.