title: Clinical course of diabetes after gastrectomy according to type of reconstruction in patients with concurrent gastric cancer and type 2 diabetes.
abstract: BACKGROUND
  This study was conducted to evaluate course of diabetes after gastrectomy according to type of reconstruction performed for gastric cancer in patients with type 2 diabetes.
  
  
  METHODS
  In total, 292 patients with concurrent gastric cancer and type 2 diabetes who underwent curative surgery from January 2000 to December 2010 were enrolled in this retrospective study. No surgery-related complications, tumor recurrence, or distant metastasis occurred within 2 years after surgery. The patients' clinical characteristics were compared according to reconstruction type. Their diabetes status was assessed 1, 6, 12, and 24 months postoperatively.
  
  
  RESULTS
  Of the 292 patients, 126 underwent distal gastrectomy with Billroth I reconstruction, 103 underwent distal gastrectomy with Billroth II reconstruction, and 63 underwent total gastrectomy with Roux-en-Y reconstruction. The operation type was significantly correlated with the outcome of type 2 diabetes mellitus 2 years postoperatively (P < 0.05), while sex, age at operation, duration of diabetes, anti-diabetes treatment method, preoperative body mass index, preoperative fasting blood glucose level, and preoperative diabetes control were not (P > 0.05). The rate of remission and improvement was significantly different at 1, 6, 12, and 24 months postoperatively in the Billroth I group (P < 0.05), but not in the Billroth II group (P > 0.05).
  
  
  CONCLUSIONS
  Patients with concurrent gastric cancer and type 2 diabetes can exhibit remission of diabetes after gastrectomy. Total gastrectomy with Roux-en-Y reconstruction was associated with the highest remission rate, while distal gastrectomy with Billroth I reconstruction showed a variable rate of remission and improvement postoperatively.
authors.affiliation: Gastrointestinal Surgery Department, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, People's Republic of China.
authors.forename: Zhenxin
authors.initials: Z
authors.lastname: Zhu
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Shan
authors.forename: Yajun
authors.initials: Y
authors.lastname: Cheng
authors.forename: Jiapeng
authors.initials: J
authors.lastname: Xu
authors.forename: Hongbing
authors.initials: H
authors.lastname: Fu
authors.forename: Weimin
authors.initials: W
authors.lastname: Wang
authors.forename: Ronglin
authors.initials: R
authors.lastname: Yan
authors.forename: Qingping
authors.initials: Q
authors.lastname: Cai
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000379:methods / Q000706:statistics & numerical data; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods* / Q000706:statistics & numerical data; D005763:Gastroenterostomy / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome