title: [Efficacy of modified Roux-en-Y gastric bypass in the treatment of non-obese type 2 diabetes mellitus:one year follow-up].
abstract: OBJECTIVE
  To evaluate the one year effect of modified Roux-en-Y gastric bypass (RYGP) in the treatment of non-obese type 2 diabetes and to investigate the reasonable indications for surgery.
  
  
  METHODS
  Totally 72 patients diagnosed as type 2 diabetes underwent RYGP from May 2009 to June 2010. There were 45 male and 27 female patients, with an average age of (47 ± 10) years. Preoperative body mass index (BMI) of the patients was 18.69 to 31.22 kg/m(2), average (26 ± 4) kg/m(2). The follow-up data included fasting plasma glucose (FPG), 2 h plasma glucose after oral glucose challenge (2hPG), weight, BMI and medication usage in 1, 3, 6 and 12 months postoperative; hemoglobin A1c (HbA1c), fasting C-peptide (C-P), fasting serum insulin (Fins) and homeostasis model assessment of insulin resistance index (HOMA-IR) in 6 and 12 months postoperative, respectively.
  
  
  RESULTS
  Compared with the preoperative, FPG, 2hPG, weight and BMI in 1, 3, 6 and 12 months after surgery were improved (t = 7.014 to 10.254, P = 0.000), while HbA1c, C-P and HOMA-IR in 6 and 12 months after surgery were improved (t = 1.782 to 7.789, P = 0.000 to 0.103) and there was no significant difference in Fins (P > 0.05). The rates of complete remission in 1, 3, 6 and 12 months after surgery were gradually improved to 22.2%, 27.8%, 36.1% and 60.6%, respectively, and the rate of remission in 1 year was 94.3%. The complete remission of 1 year after surgery was associated with normal C-P, insulin antibody and oral antidiabetic drugs (χ(2) = 11.730, P = 0.003; χ(2) = 7.131, P = 0.028;χ(2) = 6.149, P = 0.046).
  
  
  CONCLUSIONS
  Modified RYGP is safely and effectively in the treatment of no-obese type 2 diabetes patients. The function of islet cells is significantly improved after operation. Especially for the patients of whom C-P is normal, insulin antibody is negative before surgery, the rate of complete remission after 1 year is better.
authors.affiliation: Department of Hepatobiliary and Pancreatic-Spleen Surgery, Fourth Military Medical University, Xi'an, China.
authors.forename: Ya-feng
authors.initials: YF
authors.lastname: Chen
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.forename: Yan-ling
authors.initials: YL
authors.lastname: Yang
authors.forename: Nan
authors.initials: N
authors.lastname: Wu
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Zheng
authors.forename: Xiao-lei
authors.initials: XL
authors.lastname: Li
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Chen
authors.forename: Heng-li
authors.initials: HL
authors.lastname: Lian
authors.forename: Bo
authors.initials: B
authors.lastname: Song
authors.forename: Yue-jin
authors.initials: YJ
authors.lastname: Xue
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Cai
authors.forename: Ke-feng
authors.initials: KF
authors.lastname: Dou
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002096:C-Peptide / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human