title: Comparison of different gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  To determine the effect of different Roux-en-Y gastric bypass procedures in gastric carcinoma patients with type 2 diabetes mellitus.
  
  
  METHODS
  A retrospective analysis of the clinical data of 54 patients with gastric cancer and type 2 diabetes mellitus treated in the Department of General Surgery from January 2006 to June 2013 was conducted. The patients underwent gastrectomy using different Roux-en-Y gastric bypass procedures (traditional, n = 26; modified, n = 28). Fasting plasma glucose (FPG), two hour postprandial blood glucose (2 h PBG) and hemoglobin A1c (HbA1c) were analyzed before surgery (0 mo) and 1, 3 and 6 mo after surgery.
  
  
  RESULTS
  FPG and 2 h PBG levels were significantly decreased 1 mo after surgery in the traditional Roux-en-Y gastric bypass group (FPG 7.5 ± 1.3 vs 10.7 ± 1.2, P < 0.05) (2 h PBG 10.2 ± 1.8 vs 13.8 ± 3.2, P < 0.05). FPG and 2 h PBG levels were significantly decreased after surgery in the modified Roux-en-Y gastric bypass group (FPG 6.9 ± 1.2 vs 10.5 ± 1.1, 6.5 ± 1.3 vs 10.5 ± 1.1, 6.4 ± 1.2 vs 10.5 ± 1.1, P < 0.05) (2 h PBG 9.9 ± 2.2 vs 14.1 ± 2.9, 9.2 ± 2.4 vs 14.1 ± 2.9, 8.9 ± 2.6 vs 14.1 ± 2.9, P < 0.05). Compared with the levels before surgery, HbA1c levels were significantly decreased 3 and 6 mo after surgery (7.2 ± 1.1 vs 10.5 ± 1.1, 5.5 ± 1.1 vs 10.5 ± 1.1, P < 0.05). Significant differences between the two groups regarding FPG, 2 h PBG and HbA1c concentration were observed 3 and 6 mo after surgery (FPG 10.1 ± 1.5 vs 6.5 ± 1.3, 10.3 ± 1.4 vs 6.4 ± 1.2, P < 0.05) (2 h PBG 13.1 ± 2.8 vs 9.2 ± 2.4, 13.6 ± 3.1 vs 8.9 ± 2.6, P < 0.05) (HbA1c 10.1 ± 1.4 vs 7.2 ± 1.1, 10.5 ± 1.3 vs 5.5 ± 1.1, P < 0.05).
  
  
  CONCLUSIONS
  Modified Roux-en-Y gastric bypass can improve glucose metabolism in type 2 diabetic patients with gastric cancer.
authors.affiliation: Shao-Wei Xiong, Xian-Ming Liu, Zeng Liu, Department of General Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
authors.forename: Shao-Wei
authors.initials: SW
authors.lastname: Xiong
authors.affiliation: Shao-Wei Xiong, Xian-Ming Liu, Zeng Liu, Department of General Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
authors.forename: Dong-Yun
authors.initials: DY
authors.lastname: Zhang
authors.affiliation: Shao-Wei Xiong, Xian-Ming Liu, Zeng Liu, Department of General Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
authors.forename: Xian-Ming
authors.initials: XM
authors.lastname: Liu
authors.affiliation: Shao-Wei Xiong, Xian-Ming Liu, Zeng Liu, Department of General Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
authors.forename: Zeng
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Shao-Wei Xiong, Xian-Ming Liu, Zeng Liu, Department of General Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China.
authors.forename: Fang-Ting
authors.initials: FT
authors.lastname: Zhang
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002277:Carcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D005215:Fasting / Q000097:blood; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Fasting plasma glucose; Gastric cancer; Hemoglobin A1C; Roux-en-Y gastric bypass; Type 2 diabetes mellitus