title: Gastric bypass surgery in non-obese patients with type 2 diabetes mellitus: a 1-year follow-up of 58 cases in Chinese.
abstract: OBJECTIVE
  To investigate the clinical efficacy of gastric bypass surgery in non-obese patients with type 2 diabetes.
  
  
  METHODS
  Clinical data of 58 non-obese patients with type 2 diabetes (body mass index range from 22.1-25.8 kg/m(2)) were collected one year after gastric bypass surgery. Collected parameters included fasting plasma glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, fasting plasma glucagon-like peptide-1 and 2-hour postprandial plasma glucagon-like peptide-1. The insulin resistance index (HOMA-IR = fasting plasma glucose × fasting serum insulin/22.5) and the body mass index were calculated.
  
  
  RESULTS
  Of the 58 patients, 48 had stopped taking all hypoglycemic drug treatments and had achieved complete remission (82.8%). Seven patients were unable to completely withdraw from hypoglycemic agents, although their intake of drugs was reduced at least 50% compared to pre-surgical values (12.0%). Three of the cases showed no significant change in blood glucose after surgery (5.2%). In addition, values for fasting plasma glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin and HOMA-IR significantly decreased after surgery. Values for fasting plasma glucagon-like peptide-1 and 2-hour postprandial plasma glucagon-like peptide-1 significantly increased after surgery, and the body mass index at the sixth post-operative month were significantly lower than pre-operative.
  
  
  CONCLUSIONS
  For non-obese patients with type 2 diabetes, gastric bypass surgery has a significant clinical effect. Potential mechanisms include improvements in insulin resistance and/or increased endogenous intestinal glucagon-like peptide-1 secretion leading to improved insulin secretion.
authors.affiliation: General Surgery Center, Chengdu Military General Hospital Chengdu 610083, Sichuan Province, China.
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Cui
authors.affiliation: General Surgery Center, Chengdu Military General Hospital Chengdu 610083, Sichuan Province, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: General Surgery Center, Chengdu Military General Hospital Chengdu 610083, Sichuan Province, China.
authors.forename: Li
authors.initials: L
authors.lastname: Shi
authors.affiliation: General Surgery Center, Chengdu Military General Hospital Chengdu 610083, Sichuan Province, China.
authors.forename: Hong-Tao
authors.initials: HT
authors.lastname: Yan
authors.affiliation: General Surgery Center, Chengdu Military General Hospital Chengdu 610083, Sichuan Province, China.
authors.forename: Li-Jun
authors.initials: LJ
authors.lastname: Tang
keywords: Type 2 diabetes mellitus; clinical efficacy; gastric bypass surgery; glucagon-like peptide-1