title: [Impact of techniques for gastrointestinal tract reconstruction following gastrectomy on pancreatic β-cell function in patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  To evaluate the impact of different techniques for gastrointestinal tract reconstruction on postoperative pancreatic β-cell function in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Twenty-three patients with gastric cancer and T2DM were studied. Techniques for reconstruction included Billroth I (n=13) and bypass procedures(Billroth II n=4 and Roux-en-Y anastomosis n=6). Pancreatic β-cell function was evaluated by oral glucose tolerance test (OGTT). Serum insulin was measured by electrochemiluminescence immunoassay and blood glucose by glucose oxidase method. HOMA-IR and HOMA-β were assessed.
  
  
  RESULTS
  T2DM remission rate was 90% (9/10) in the bypass group, and 23% (3/13) in Billroth I group (P<0.01). Glycosylated hemoglobin A1c and glycated hemoglobin HbA1 were improved significantly in patients after bypass procedures(P<0.05), but the difference in Billroth I group was not statistically significant (P>0.05). OGTT showed that fasting and post-glucose load plasma glucose at each time point were significantly lower in the bypass group compared to the Billroth I group. At 30 minutes and 60 minutes after glucose load, insulin levels and insulin release index were significantly higher in the bypass group compared to Billroth I( group, as were levels of HOMA-β and ΔI30/ΔG30 in the bypass group(P<0.05).
  
  
  CONCLUSIONS
  Gastrointestinal bypass following gastrectomy may induce resolution of T2DM and improve β-cells function.
authors.affiliation: Department of Minimally Invasive Surgery, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China. caijingli2005@163.com
authors.forename: Jing-li
authors.initials: JL
authors.lastname: Cai
authors.forename: Bao-qing
authors.initials: BQ
authors.lastname: Li
authors.forename: Chao
authors.initials: C
authors.lastname: Zheng
authors.forename: Xiao-kun
authors.initials: XK
authors.lastname: Lin
authors.forename: Kai
authors.initials: K
authors.lastname: Yin
authors.forename: Jia-rong
authors.initials: JR
authors.lastname: Xu
authors.forename: Lu-bai
authors.initials: LB
authors.lastname: Xu
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005743:Gastrectomy; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery