title: A Comparative Study of the Effect of Gastric Bypass, Sleeve Gastrectomy, and Duodenal-Jejunal Bypass on Type-2 Diabetes in non-Obese Rats.
abstract: BACKGROUND
  We compared the therapeutic effects of Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and duodenal-jejunal bypass (DJB) on type-2 diabetes mellitus (T2DM) in non-obese rats using clamp testing.
  
  
  METHODS
  Goto-Kakizaki rats (non-obese rats with T2DM) underwent surgery: RYGB, SG, or DJB. Rats were observed for 8 weeks after surgery to evaluate weight changes. Levels of glucose, insulin, and glucagon-like peptide (GLP)-1 were determined 2, 4, 6, and 8 weeks after surgery. An oral glucose tolerance test (OGTT) and clamp test was used to evaluate glucose tolerance and insulin resistance.
  
  
  RESULTS
  Rats in RYGB, SG, and DJB groups weighed significantly less than sham-group rats 6 and 8 weeks after surgery. Fasting blood glucose levels of RYGB, SG, and DJB rats were significantly lower than preoperative levels. One month after surgery, the area under the curve of the OGTT (in mmol•h/L) for RYGB, SG, DJB, and sham surgery groups was 38.9 ± 5.9, 50.9 ± 2.9, 46.8 ± 3.3, and 67.4 ± 6.0, respectively; there was no significant difference in glucose levels of SG and DJB groups. Glucose infusion rates (in mg/(kg•min)) were 18.3 ± 2.7, 17.2 ± 2.1, and 16.8 ± 1.9 in hyperinsulinemic-euglycemic-clamped RYGB, DJB, and SG rats, respectively, 8 weeks after surgery. The rate in the sham surgery group was 6.3 ± 0.9. Area under plasma insulin curves 8 weeks after surgery in hyperglycemic-clamped RYGB, DJB, SG, and sham surgery rats (in mU•h/L) were 98.8 ± 7.0, 84.4 ± 6.1, 89.0 ± 7.1, and 22.6 ± 2.6, respectively.
  
  
  CONCLUSIONS
  The three surgical methods described alleviated T2DM and reduced insulin resistance in non-obese rats with T2DM.
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, No 12, Middle Wulumuqi Road, Shanghai, 200040, China, hsubo@163.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Yan
authors.forename: Yikai
authors.initials: Y
authors.lastname: Shao
authors.forename: Qiwei
authors.initials: Q
authors.lastname: Shen
authors.forename: Rong
authors.initials: R
authors.lastname: Hua
authors.forename: Rui
authors.initials: R
authors.lastname: Ding
authors.forename: Qiyuan
authors.initials: Q
authors.lastname: Yao
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000601:surgery*; D004386:Duodenum / Q000601:surgery; D005743:Gastrectomy; D015390:Gastric Bypass; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D015309:Glucose Clamp Technique; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007583:Jejunum / Q000601:surgery; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains
chemical_list: D001786:Blood Glucose; D007328:Insulin; D052216:Glucagon-Like Peptide 1