J Korean Surg Soc.  2013 Sep;85(3):109-115. 10.4174/jkss.2013.85.3.109.

The effect of duodenojejunal bypass for type 2 diabetes mellitus patients below body mass index 25 kg/m2: one year follow-up

• Heo Y
• Ahn JH
• Shin SH
• Lee YJ

• KMID: 1426342
• DOI: http://doi.org/10.4174/jkss.2013.85.3.109

Abstract

PURPOSE
The goals of this study are to evaluate the effect of duodenojejunal bypass (DJB) for type 2 diabetes mellitus (T2DM) patients below body mass index (BMI) 25 kg/m2 in one year follow-up, and to compare the results of 1 week which we have reported in 2011.
METHODS
In this prospective observational study, there were 31 type 2 diabetic patients who underwent DJB at Inha University Hospital from July 2009 to January 2011. We did laboratories such as 75-g oral glucose tolerance test (OGTT), insulin level and hemoglobin A1c (HbA1c), etc. and compared their changes of preoperative, a week, 3 months, and 12 months.
RESULTS
Mean BMI was 23.1 +/- 1.3 kg/m2, mean duration of T2DM was 8.3 +/- 4.7 and mean age was 46.6 +/- 7.7 years. There were a significant decrease of 75-g OGTT levels and increase of insulin secretion after 3 months. 13.3% showed diabetic remission (HbA1c < 6.0, medication cessation) and 26.7% showed diabetic improvement. The rates of remission and improvement much declined comparing with that of postoperative 1 week although those were determined by fasting and postprandial 2 hour level of glucose.
CONCLUSION
This is the first study of metabolic surgery in Korean diabetes patients in the healthy weight range. DJB exerted positive influences on insulin resistance as well as beta cell function. Early effects on T2DM after DJB could be estimated as one of good modalities, although the effectiveness seems to be unacceptable. Further studies are mandatory for evaluation of the effectiveness of metabolic surgery and finding prognostic factors.

Keyword

Type 2 diabetes mellitus; Metabolic surgery; Duodenojejunal bypass

MeSH Terms

Body Mass Index
Diabetes Mellitus, Type 2
Fasting
Follow-Up Studies
Glucose Tolerance Test
Hemoglobins
Humans
Insulin
Insulin Resistance
Prospective Studies
Hemoglobins
Insulin

Figure

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  Fig. 1 Comparison of 75-g oral glucose tolerance test between preoperation, postoperation, 3 months, and 12 months. Glucose levels compared with those of preoperative: all level are P < 0.05, except 30 minutes at 3 months and basal at 12 months.

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  Fig. 2 Comparison of Insulin level between preoperation, postoperation, 3 months, and 12 months. Insulin levels compared with those of preoperative: P < 0.05 in all of 1 week, 60 minutes at 3 months and 12 months.

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