title: The better effect of Roux-en-Y gastrointestinal reconstruction on blood glucose of nonobese type 2 diabetes mellitus patients.
abstract: BACKGROUND
  Given the role of gastrointestinal reconstruction, we investigated whether Roux-en-Y gastrointestinal reconstruction (RYGR) and Billroth I reconstruction (B1R) can improve glucose in nonobese type 2 diabetes mellitus patients.
  
  
  METHODS
  Seventy-six nonobese type 2 diabetes mellitus patients underwent open subtotal gastrectomy with RYGR and B1R between January 2005 and January 2010 in our hospital. Besides demographic data, preoperative weight, glucose, hemoglobin A1c, ghrelin, and glucagon-like peptide 1 were determined.
  
  
  RESULTS
  As defined previously, 2 of 35 patients with RYGR were cured, 5 patients were controlled, and 10 patients were improved; similarly, 2 of 41 patients with B1R were controlled, and 3 patients improved 12 months after surgery. The fasting glucose and hemoglobin A1c decreased more significantly in RYGR patients (P < .05). Moreover, a higher fasting plasma GLP-1 level in RYGR patients and lower ghrelin in B1R patients were noted after surgery (P < .05).
  
  
  CONCLUSIONS
  RYGR shows a more effective amelioration in nonobese type 2 diabetes mellitus patients.
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan 250012, Shandong, China.
authors.forename: Weijie
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan 250012, Shandong, China.
authors.forename: Zhibo
authors.initials: Z
authors.lastname: Yan
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan 250012, Shandong, China.
authors.forename: Shaozhuang
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan 250012, Shandong, China.
authors.forename: Guangyong
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan 250012, Shandong, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan 250012, Shandong, China. Electronic address: husanyuan1962@hotmail.com.
authors.forename: Sanyuan
authors.initials: S
authors.lastname: Hu
mesh_terms: D000713:Anastomosis, Roux-en-Y; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005763:Gastroenterostomy; D054439:Ghrelin / Q000097:blood; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D054439:Ghrelin; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin
keywords: Blood glucose; Gastric bypass surgery; Type 2 diabetes mellitus