Effect Of Roux-en-Y Gastric Bypass With Different Gastric Sac Sizes On T2DM Patients With BMI Of 30～35 Kg/m~2

Objectives:The purpose of this study is as follows.The abnormal influence of gastric capsule size in T2DM patients was evaluated in two important BMI(30～35kg/m2)and rhgb patients in China.Methods:In this randomized,prospective study,we evaluated the efficacy of RYGB for small(10～20 ml)and large(25～35 ml)gastric sacs in 73 Obese Chinese patients(39 women and 34 men).According to protocol,all patients were divided into two groups,small gastric sac size group and large gastric sac size group,and underwent RYGB surgery.The main criteria included in the study were(a)a diagnosis of type 2 diabetes(Glycated hemoglobin>7.0%),(b)a measured BMI of at least 30kg/m2 and not yet 35kg/m2,(c)patients between 25 and 60 years of age,and(d)patients who had previously undergone complex abdominal surgery or bariatric surgery,Student:Excluded.Weight loss,body mass index,percentage of excess weight loss(%EWL),Glycated hemoglobin and fasting blood glucose were assessed at 3,6,12 months and 2 years postoperatively.Results:Of 85 patients,73(91%)were followed up 2 years after surgery.At 2 years,the small gastric sac group had a mean weight loss of 13.3kg[95%CI(-15.3～-11.3)];%EWL was 52.3%[95%CI(48.8～63.6%)],Compared with the large gastric sac group,the average body weight was reduced by 8.9 kg[95%CI(-12.9～-4.9)],and the average%EWL was 45.5%[95%CI(43.2～58.9)](all P<0.05).Glycemic control was improved in both groups,with a mean decrease in Glycated hemoglobin levels of 3.8%[95%CI(-4.1 to-3.5)]in the small gastric sac group and 3.6%[95%CI(-4.2～-3.1)]in the large gastric sac group(P=0.019,P<0.0 5).Postoperatively,fasting blood glucose levels decreased significantly,with the mean levels of 4.6mmol/L[95%CI(-5.1～-4.1)]and 3.0 mmol/L[95%CI(-3.6～-2.5)]in the large and small gastric sac group(P=0.001,P<0.0 5).Conclusions:in this short-term study,in Chinese T2DM patients with body mass index(BMI)of 30～35kg/m2,we observed that larger small gastric sac size was more effective in weight loss and glycemic control than small small gastric sac size.However,long-term follow-up and large sample studies are needed to confirm these results in the future.