title: Improvement of diabetes and hypertension after gastrectomy: a nationwide cohort study.
abstract: OBJECTIVE
  To evaluate the effect of gastrectomy on diabetes mellitus (DM) and hypertension (HTN) in non-obese gastric cancer patients.
  
  
  METHODS
  A total of 100000 patients, diagnosed with either type 2 DM or HTN, were randomly selected from the 2004 Korean National Health Insurance System claims. Among them, 360 diabetes and 351 hypertensive patients with gastric cancer who had been regularly treated without chemotherapy from January 2005 to December 2010 were selected. They were divided into three groups according to their treatment methods: total gastrectomy (TG), subtotal gastrectomy (STG) and endoscopic resection (ER).
  
  
  RESULTS
  The drug discontinuation rate of anti-diabetic and anti-hypertensive agents after gastric cancer treatment was 9.7% and 11.1% respectively. DM appeared to be improved more frequently (22.8%) and earlier (mean±SE 28.6±1.8 mo) in TG group than in the two other groups [improved in 9.5% of ER group (37.4±1.1 mo) and 6.4% of STG group (47.0±0.8 mo)]. The proportion of patients treated with multiple drugs decreased more notably in TG group compared to others (P=0.001 in DM, and P=0.035 in HTN). In TG group, adjusted hazard ratio for the improvement of DM was 2.87 (95%CI: 1.15-7.17) in a multi-variate analysis and better control of DM was observed with survival analysis (P<0.001).
  
  
  CONCLUSIONS
  TG was found to decrease the need for anti-diabetic medications which can be reflective of improved glycemic control, to a greater extent than either ER or STG in non-obese diabetic patients.
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Eun Kyung
authors: EK
authors: Lee
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: So Young
authors: SY
authors: Kim
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: You Jin
authors: YJ
authors: Lee
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Mi Hyang
authors: MH
authors: Kwak
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Hak Jin
authors: HJ
authors: Kim
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Il Ju
authors: IJ
authors: Choi
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Soo-Jeong
authors: SJ
authors: Cho
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Young Woo
authors: YW
authors: Kim
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Jong Yeul
authors: JY
authors: Lee
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Chan Gyoo
authors: CG
authors: Kim
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Hong Man
authors: HM
authors: Yoon
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Bang Wool
authors: BW
authors: Eom
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Sun-Young
authors: SY
authors: Kong
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Min Kyong
authors: MK
authors: Yoo
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Jong Hyock
authors: JH
authors: Park
authors: Eun Kyung Lee, You Jin Lee, Mi Hyang Kwak, Hak Jin Kim, Il Ju Choi, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Department of Internal Medicine, National Cancer Center, Goyang 410-769, South Korea.
authors: Keun Won
authors: KW
authors: Ryu
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D016009:Chi-Square Distribution; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D004359:Drug Therapy, Combination; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D005773:Gastroscopy; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D020127:Recovery of Function; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents
keywords: Diabetes; Gastrectomy; Gastric cancer; Hypertension; National cohort
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