Improved glycemic control with proximal intestinal bypass and weight loss following gastrectomy in non-obese diabetic gastric cancer patients

Ali Guner, Minah Cho, Taeil Son, Hyoung Il Kim, Sung Hoon Noh, WooJin Hyung

Research output: Contribution to journalArticle

Abstract

Purpose: The aim of this study was to assess whether gastrectomy influences glycemic control in non-obese diabetic gastric cancer patients and to identify factors related to glucose metabolism after gastrectomy. Materials and Methods: We retrospectively analyzed changes in glucose metabolism in 238 non-obese (body mass index < 30 kg/m2) patients with type II diabetes who underwent distal gastrectomy with either gastroduodenostomy (n = 91) or gastrojejunostomy (n = 147) for stage I gastric cancer. We collected demographics, diabetes-related features, surgery-related features, and changes in glucose metabolism during follow-up. The effect of surgery on the course of diabetes was evaluated at different time points according to fasting blood glucose levels and use of diabetes-related medication. Results: Preoperatively, the mean body mass index was 24.3 ± 2.3. Weight, body mass index and fasting blood glucose of all patients were significantly lower compared to preoperative levels at all time points. Weight loss after 6 months and the percentage of patients whose weight loss ratio was higher than 10% after one year were greater in the gastrojejunostomy group than the gastroduodenostomy group. Overall, 88 (37%) patients showed improvement in their diabetes course at one month after surgery; 152 (64%) showed improvement after 2 years. Duration of diabetes, weight loss, and reconstruction type were associated with improvement in diabetes at different time points. At 6 months and thereafter, the percentage of patients with an improved diabetes course was highest in the gastrojejunostomy plus higher than 10% weight loss group. Conclusions: Although weight loss may be associated with adverse effects of gastrectomy, postoperative weight loss in an acceptable range is a useful measure of the better glycemic control for the group of diabetic patients. Selecting gastrojejunostomy during gastrectomy and inducing acceptable weight loss after gastrectomy could be beneficial to the non-obese diabetic gastric cancer patients for improved glycemic control.

Original languageEnglish
Pages (from-to)104605-104614
Number of pages10
JournalOncotarget
Volume8
Issue number61
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Jejunoileal Bypass
Gastrectomy
Stomach Neoplasms
Weight Loss
Gastric Bypass
Body Mass Index
Glucose
Blood Glucose
Fasting
Type 2 Diabetes Mellitus
Demography
Weights and Measures
Control Groups

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Guner, Ali ; Cho, Minah ; Son, Taeil ; Kim, Hyoung Il ; Noh, Sung Hoon ; Hyung, WooJin. / Improved glycemic control with proximal intestinal bypass and weight loss following gastrectomy in non-obese diabetic gastric cancer patients. In: Oncotarget. 2017 ; Vol. 8, No. 61. pp. 104605-104614.
@article{5bc15869b2624aec8b63ca39c6c0c88c,
title = "Improved glycemic control with proximal intestinal bypass and weight loss following gastrectomy in non-obese diabetic gastric cancer patients",
abstract = "Purpose: The aim of this study was to assess whether gastrectomy influences glycemic control in non-obese diabetic gastric cancer patients and to identify factors related to glucose metabolism after gastrectomy. Materials and Methods: We retrospectively analyzed changes in glucose metabolism in 238 non-obese (body mass index < 30 kg/m2) patients with type II diabetes who underwent distal gastrectomy with either gastroduodenostomy (n = 91) or gastrojejunostomy (n = 147) for stage I gastric cancer. We collected demographics, diabetes-related features, surgery-related features, and changes in glucose metabolism during follow-up. The effect of surgery on the course of diabetes was evaluated at different time points according to fasting blood glucose levels and use of diabetes-related medication. Results: Preoperatively, the mean body mass index was 24.3 ± 2.3. Weight, body mass index and fasting blood glucose of all patients were significantly lower compared to preoperative levels at all time points. Weight loss after 6 months and the percentage of patients whose weight loss ratio was higher than 10{\%} after one year were greater in the gastrojejunostomy group than the gastroduodenostomy group. Overall, 88 (37{\%}) patients showed improvement in their diabetes course at one month after surgery; 152 (64{\%}) showed improvement after 2 years. Duration of diabetes, weight loss, and reconstruction type were associated with improvement in diabetes at different time points. At 6 months and thereafter, the percentage of patients with an improved diabetes course was highest in the gastrojejunostomy plus higher than 10{\%} weight loss group. Conclusions: Although weight loss may be associated with adverse effects of gastrectomy, postoperative weight loss in an acceptable range is a useful measure of the better glycemic control for the group of diabetic patients. Selecting gastrojejunostomy during gastrectomy and inducing acceptable weight loss after gastrectomy could be beneficial to the non-obese diabetic gastric cancer patients for improved glycemic control.",
author = "Ali Guner and Minah Cho and Taeil Son and Kim, {Hyoung Il} and Noh, {Sung Hoon} and WooJin Hyung",
year = "2017",
month = "1",
day = "1",
doi = "10.18632/oncotarget.22262",
language = "English",
volume = "8",
pages = "104605--104614",
journal = "Oncotarget",
issn = "1949-2553",
publisher = "Impact Journals",
number = "61",

}

Improved glycemic control with proximal intestinal bypass and weight loss following gastrectomy in non-obese diabetic gastric cancer patients. / Guner, Ali; Cho, Minah; Son, Taeil; Kim, Hyoung Il; Noh, Sung Hoon; Hyung, WooJin.

In: Oncotarget, Vol. 8, No. 61, 01.01.2017, p. 104605-104614.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Improved glycemic control with proximal intestinal bypass and weight loss following gastrectomy in non-obese diabetic gastric cancer patients

AU - Guner, Ali

AU - Cho, Minah

AU - Son, Taeil

AU - Kim, Hyoung Il

AU - Noh, Sung Hoon

AU - Hyung, WooJin

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Purpose: The aim of this study was to assess whether gastrectomy influences glycemic control in non-obese diabetic gastric cancer patients and to identify factors related to glucose metabolism after gastrectomy. Materials and Methods: We retrospectively analyzed changes in glucose metabolism in 238 non-obese (body mass index < 30 kg/m2) patients with type II diabetes who underwent distal gastrectomy with either gastroduodenostomy (n = 91) or gastrojejunostomy (n = 147) for stage I gastric cancer. We collected demographics, diabetes-related features, surgery-related features, and changes in glucose metabolism during follow-up. The effect of surgery on the course of diabetes was evaluated at different time points according to fasting blood glucose levels and use of diabetes-related medication. Results: Preoperatively, the mean body mass index was 24.3 ± 2.3. Weight, body mass index and fasting blood glucose of all patients were significantly lower compared to preoperative levels at all time points. Weight loss after 6 months and the percentage of patients whose weight loss ratio was higher than 10% after one year were greater in the gastrojejunostomy group than the gastroduodenostomy group. Overall, 88 (37%) patients showed improvement in their diabetes course at one month after surgery; 152 (64%) showed improvement after 2 years. Duration of diabetes, weight loss, and reconstruction type were associated with improvement in diabetes at different time points. At 6 months and thereafter, the percentage of patients with an improved diabetes course was highest in the gastrojejunostomy plus higher than 10% weight loss group. Conclusions: Although weight loss may be associated with adverse effects of gastrectomy, postoperative weight loss in an acceptable range is a useful measure of the better glycemic control for the group of diabetic patients. Selecting gastrojejunostomy during gastrectomy and inducing acceptable weight loss after gastrectomy could be beneficial to the non-obese diabetic gastric cancer patients for improved glycemic control.

AB - Purpose: The aim of this study was to assess whether gastrectomy influences glycemic control in non-obese diabetic gastric cancer patients and to identify factors related to glucose metabolism after gastrectomy. Materials and Methods: We retrospectively analyzed changes in glucose metabolism in 238 non-obese (body mass index < 30 kg/m2) patients with type II diabetes who underwent distal gastrectomy with either gastroduodenostomy (n = 91) or gastrojejunostomy (n = 147) for stage I gastric cancer. We collected demographics, diabetes-related features, surgery-related features, and changes in glucose metabolism during follow-up. The effect of surgery on the course of diabetes was evaluated at different time points according to fasting blood glucose levels and use of diabetes-related medication. Results: Preoperatively, the mean body mass index was 24.3 ± 2.3. Weight, body mass index and fasting blood glucose of all patients were significantly lower compared to preoperative levels at all time points. Weight loss after 6 months and the percentage of patients whose weight loss ratio was higher than 10% after one year were greater in the gastrojejunostomy group than the gastroduodenostomy group. Overall, 88 (37%) patients showed improvement in their diabetes course at one month after surgery; 152 (64%) showed improvement after 2 years. Duration of diabetes, weight loss, and reconstruction type were associated with improvement in diabetes at different time points. At 6 months and thereafter, the percentage of patients with an improved diabetes course was highest in the gastrojejunostomy plus higher than 10% weight loss group. Conclusions: Although weight loss may be associated with adverse effects of gastrectomy, postoperative weight loss in an acceptable range is a useful measure of the better glycemic control for the group of diabetic patients. Selecting gastrojejunostomy during gastrectomy and inducing acceptable weight loss after gastrectomy could be beneficial to the non-obese diabetic gastric cancer patients for improved glycemic control.

UR - http://www.scopus.com/inward/record.url?scp=85035346080&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85035346080&partnerID=8YFLogxK

U2 - 10.18632/oncotarget.22262

DO - 10.18632/oncotarget.22262

M3 - Article

AN - SCOPUS:85035346080

VL - 8

SP - 104605

EP - 104614

JO - Oncotarget

JF - Oncotarget

SN - 1949-2553

IS - 61

ER -