Outcome after gastrectomy in gastric cancer patients with type 2 diabetes

Jong Won Kim, Jae Ho Cheong, WooJin Hyung, Seung Ho Choi, Sung Hoon Noh

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

AIM: To evaluate the prognosis of type II diabetes mellitus (T2DM) after gastrectomy and related factors in gastric cancer patients. METHODS: 403 gastric cancer patients with T2DM were studied, who underwent gastrectomy between May 2003 and September 2009. A review of medical records and telephone interviews was performed in this cross-sectional study. The factors included in the statistical analysis were as follows: gender, age, type of surgery, preoperative body mass index (BMI), current BMI, BMI reduction ratio, preoperative insulin or oral diabetic medicine requirement, follow-up duration, and current state of diabetes. Assessment of diabetes status after surgery was classified into four categories according to the change in hypoglycemic agents after surgery and present status of T2DM: resolution, improvement, same, and worse. RESULTS: The mean follow-up duration was 33.7 mo(± 20.6 mo), preoperative BMI was 24.7 kg/m 2 (± 3.0 kg/m 2), and BMI reduction ratio was 9.8% (± 8.6%). After surgery, T2DM was cured in 58 patients (15.1%) and was improved in 117 patients (30.4%). According to the type of surgery, the BMI reduction ratio was significantly higher in the total gastrectomy and Roux-en-Y reconstruction group [14.2% ± 9.2% vs 9.2% ± 7.7% (Billroth II group), P < 0.001] and significantly lower in the subtotal gastrectomy and Billroth I reconstruction group [7.6% ± 8.0%, 9.2% ± 7.7% (Billroth II group), P < 0.001]. The BMI reduction ratio, follow-up duration after surgery, type of surgery, extent of gastrectomy, and performance of duodenal bypass were significantly correlated to the course of T2DM (P < 0.05). The BMI reduction ratio was the most influential factor on T2DM status. In a subgroup analysis of patients with a BMI reduction ratio of 10% or less (n = 206), T2DM was cured in 15 (7.6%) patients and was improved in 57 (28.8%) patients after surgery, and only the duration of surgery was significantly correlated to T2DM status (P = 0.022). CONCLUSION: The course of T2DM was significantly correlated to the BMI reduction ratio but not to the type of surgery without a significant change in BMI.

Original languageEnglish
Pages (from-to)49-54
Number of pages6
JournalWorld Journal of Gastroenterology
Volume18
Issue number1
DOIs
Publication statusPublished - 2012 Jan 7

Fingerprint

Gastrectomy
Type 2 Diabetes Mellitus
Stomach Neoplasms
Body Mass Index
Gastroenterostomy
Oral Medicine
Hypoglycemic Agents
Medical Records
Cross-Sectional Studies
Interviews
Insulin

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Kim, Jong Won ; Cheong, Jae Ho ; Hyung, WooJin ; Choi, Seung Ho ; Noh, Sung Hoon. / Outcome after gastrectomy in gastric cancer patients with type 2 diabetes. In: World Journal of Gastroenterology. 2012 ; Vol. 18, No. 1. pp. 49-54.
@article{332f304571f047bfb8b8ae1ce5b51935,
title = "Outcome after gastrectomy in gastric cancer patients with type 2 diabetes",
abstract = "AIM: To evaluate the prognosis of type II diabetes mellitus (T2DM) after gastrectomy and related factors in gastric cancer patients. METHODS: 403 gastric cancer patients with T2DM were studied, who underwent gastrectomy between May 2003 and September 2009. A review of medical records and telephone interviews was performed in this cross-sectional study. The factors included in the statistical analysis were as follows: gender, age, type of surgery, preoperative body mass index (BMI), current BMI, BMI reduction ratio, preoperative insulin or oral diabetic medicine requirement, follow-up duration, and current state of diabetes. Assessment of diabetes status after surgery was classified into four categories according to the change in hypoglycemic agents after surgery and present status of T2DM: resolution, improvement, same, and worse. RESULTS: The mean follow-up duration was 33.7 mo(± 20.6 mo), preoperative BMI was 24.7 kg/m 2 (± 3.0 kg/m 2), and BMI reduction ratio was 9.8{\%} (± 8.6{\%}). After surgery, T2DM was cured in 58 patients (15.1{\%}) and was improved in 117 patients (30.4{\%}). According to the type of surgery, the BMI reduction ratio was significantly higher in the total gastrectomy and Roux-en-Y reconstruction group [14.2{\%} ± 9.2{\%} vs 9.2{\%} ± 7.7{\%} (Billroth II group), P < 0.001] and significantly lower in the subtotal gastrectomy and Billroth I reconstruction group [7.6{\%} ± 8.0{\%}, 9.2{\%} ± 7.7{\%} (Billroth II group), P < 0.001]. The BMI reduction ratio, follow-up duration after surgery, type of surgery, extent of gastrectomy, and performance of duodenal bypass were significantly correlated to the course of T2DM (P < 0.05). The BMI reduction ratio was the most influential factor on T2DM status. In a subgroup analysis of patients with a BMI reduction ratio of 10{\%} or less (n = 206), T2DM was cured in 15 (7.6{\%}) patients and was improved in 57 (28.8{\%}) patients after surgery, and only the duration of surgery was significantly correlated to T2DM status (P = 0.022). CONCLUSION: The course of T2DM was significantly correlated to the BMI reduction ratio but not to the type of surgery without a significant change in BMI.",
author = "Kim, {Jong Won} and Cheong, {Jae Ho} and WooJin Hyung and Choi, {Seung Ho} and Noh, {Sung Hoon}",
year = "2012",
month = "1",
day = "7",
doi = "10.3748/wjg.v18.i1.49",
language = "English",
volume = "18",
pages = "49--54",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "1",

}

Outcome after gastrectomy in gastric cancer patients with type 2 diabetes. / Kim, Jong Won; Cheong, Jae Ho; Hyung, WooJin; Choi, Seung Ho; Noh, Sung Hoon.

In: World Journal of Gastroenterology, Vol. 18, No. 1, 07.01.2012, p. 49-54.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcome after gastrectomy in gastric cancer patients with type 2 diabetes

AU - Kim, Jong Won

AU - Cheong, Jae Ho

AU - Hyung, WooJin

AU - Choi, Seung Ho

AU - Noh, Sung Hoon

PY - 2012/1/7

Y1 - 2012/1/7

N2 - AIM: To evaluate the prognosis of type II diabetes mellitus (T2DM) after gastrectomy and related factors in gastric cancer patients. METHODS: 403 gastric cancer patients with T2DM were studied, who underwent gastrectomy between May 2003 and September 2009. A review of medical records and telephone interviews was performed in this cross-sectional study. The factors included in the statistical analysis were as follows: gender, age, type of surgery, preoperative body mass index (BMI), current BMI, BMI reduction ratio, preoperative insulin or oral diabetic medicine requirement, follow-up duration, and current state of diabetes. Assessment of diabetes status after surgery was classified into four categories according to the change in hypoglycemic agents after surgery and present status of T2DM: resolution, improvement, same, and worse. RESULTS: The mean follow-up duration was 33.7 mo(± 20.6 mo), preoperative BMI was 24.7 kg/m 2 (± 3.0 kg/m 2), and BMI reduction ratio was 9.8% (± 8.6%). After surgery, T2DM was cured in 58 patients (15.1%) and was improved in 117 patients (30.4%). According to the type of surgery, the BMI reduction ratio was significantly higher in the total gastrectomy and Roux-en-Y reconstruction group [14.2% ± 9.2% vs 9.2% ± 7.7% (Billroth II group), P < 0.001] and significantly lower in the subtotal gastrectomy and Billroth I reconstruction group [7.6% ± 8.0%, 9.2% ± 7.7% (Billroth II group), P < 0.001]. The BMI reduction ratio, follow-up duration after surgery, type of surgery, extent of gastrectomy, and performance of duodenal bypass were significantly correlated to the course of T2DM (P < 0.05). The BMI reduction ratio was the most influential factor on T2DM status. In a subgroup analysis of patients with a BMI reduction ratio of 10% or less (n = 206), T2DM was cured in 15 (7.6%) patients and was improved in 57 (28.8%) patients after surgery, and only the duration of surgery was significantly correlated to T2DM status (P = 0.022). CONCLUSION: The course of T2DM was significantly correlated to the BMI reduction ratio but not to the type of surgery without a significant change in BMI.

AB - AIM: To evaluate the prognosis of type II diabetes mellitus (T2DM) after gastrectomy and related factors in gastric cancer patients. METHODS: 403 gastric cancer patients with T2DM were studied, who underwent gastrectomy between May 2003 and September 2009. A review of medical records and telephone interviews was performed in this cross-sectional study. The factors included in the statistical analysis were as follows: gender, age, type of surgery, preoperative body mass index (BMI), current BMI, BMI reduction ratio, preoperative insulin or oral diabetic medicine requirement, follow-up duration, and current state of diabetes. Assessment of diabetes status after surgery was classified into four categories according to the change in hypoglycemic agents after surgery and present status of T2DM: resolution, improvement, same, and worse. RESULTS: The mean follow-up duration was 33.7 mo(± 20.6 mo), preoperative BMI was 24.7 kg/m 2 (± 3.0 kg/m 2), and BMI reduction ratio was 9.8% (± 8.6%). After surgery, T2DM was cured in 58 patients (15.1%) and was improved in 117 patients (30.4%). According to the type of surgery, the BMI reduction ratio was significantly higher in the total gastrectomy and Roux-en-Y reconstruction group [14.2% ± 9.2% vs 9.2% ± 7.7% (Billroth II group), P < 0.001] and significantly lower in the subtotal gastrectomy and Billroth I reconstruction group [7.6% ± 8.0%, 9.2% ± 7.7% (Billroth II group), P < 0.001]. The BMI reduction ratio, follow-up duration after surgery, type of surgery, extent of gastrectomy, and performance of duodenal bypass were significantly correlated to the course of T2DM (P < 0.05). The BMI reduction ratio was the most influential factor on T2DM status. In a subgroup analysis of patients with a BMI reduction ratio of 10% or less (n = 206), T2DM was cured in 15 (7.6%) patients and was improved in 57 (28.8%) patients after surgery, and only the duration of surgery was significantly correlated to T2DM status (P = 0.022). CONCLUSION: The course of T2DM was significantly correlated to the BMI reduction ratio but not to the type of surgery without a significant change in BMI.

UR - http://www.scopus.com/inward/record.url?scp=84862974951&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84862974951&partnerID=8YFLogxK

U2 - 10.3748/wjg.v18.i1.49

DO - 10.3748/wjg.v18.i1.49

M3 - Article

VL - 18

SP - 49

EP - 54

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 1

ER -