Duodenal-jejunal bypass for the treatment of type 2 diabetes in Chinese patients with an average body mass index<24 kg/m2.
BACKGROUND
It is frequently reported that bariatric surgery often leads to resolution of type 2 diabetes mellitus (T2 DM). Limited experience with duodenal-jejunal bypass (DJB) for the treatment of T2 DM has shown controversial results. We present the first study of DJB for T2 DM patients in China. The objective of this study was to evaluate the effects of DJB in nonobese Chinese patients with T2 DM.


METHODS
From March 2009 to March 2011, a total of 10 T2 DM patients with an average body mass index (BMI) of 23.8 ± 1.2 kg/m(2) were enrolled in the study. DJB was performed in all patients. BMI and glycometabolic parameters were collected at baseline and 1, 3, 6, 12, and 24 months postoperatively. Remission of T2 DM was defined as a glycosylated hemoglobin (HbA1c) level of<7% without diabetic medication.


RESULTS
Remission of T2 DM was observed in 1 (10%) of 10 T2 DM patients at 6 months. Without increasing antihyperglycemic agents, fasting plasma glucose (FPG), 2-hour postprandial plasma glucose, and HbA1c decreased significantly at each postoperative time point, compared with the preoperative baseline. BMI statistically decreased at 1 and 3 months, but did not reach statistical significance at 6, 12, and 24 months.


CONCLUSIONS
DJB can improve glycemic control in nonobese T2 DM patients without significant weight loss but may not be effective enough to induce remission of T2 DM in nonobese Chinese patients. A larger sample size and more constrictive inclusion criteria may be required for better evaluation.
Metabolic & Bariatric Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Feizhao
F
Jiang
Metabolic & Bariatric Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China. Electronic address: dr.brownhenry@yahoo.com.
Hengliang
H
Zhu
Metabolic & Bariatric Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Xiaofeng
X
Zheng
Metabolic & Bariatric Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Jinfu
J
Tu
Metabolic & Bariatric Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Weijian
W
Zhang
Metabolic & Bariatric Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China.
Xuemeng
X
Xie
D000328:Adult; D000714:Anastomosis, Surgical; D044466:Asian People; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
Bariatric surgery; DJB; Duodenal-jejunal bypass; Type 2 diabetes mellitus