title: Gastric bypass procedure for type 2 diabetes patients with BMI <28 kg/m2.
abstract: To evaluate the Roux-en-Y gastric bypass (GBP) procedure for patients suffering from type 2 diabetes mellitus (T2DM) with body mass index (BMI) <28 kg/m2.
  
  
  
  Thirty-one patients suffering from T2DM were selected to undergo laparoscopic Roux-en-Y gastric bypass surgery and were enrolled at Beijing Shijitan Hospital between November 2012 and December 2014. The fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), C-peptide, fasting insulin (FINS) and glucagon-like peptide-1 (GLP-1) of all patients were measured before and at 1, 3, 6 months after surgery. The results were compared and analyzed.
  
  
  
  Thirty-one patients suffering from T2DM successfully underwent GBP surgery (a mean age of 46 years), 14 were male and 17 were female. Among them, 7 patients had hypertriglyceridemia (HTG). The patients were followed up for 6 months. No major complications were found. The average BMI was 26.5 ± 1.4 kg/m2before surgery. The average levels of FPG, HbA1c, C-peptide, FINS of all patients were statistically decreased after surgery, respectively, compared to those before surgery (P < 0.05). However, the mean GLP-1 of all patients was statistically increased after surgery compared to that before surgery (P < 0.05). At 6 months after surgery, 22 patients (71 %) achieved complete remission of T2DM with HbA1c < 6.5 %, 7 patients (23 %) gained partial remission of T2DM with 6.5 % ≤ HbA1c < 7.0 % and 2 patients (6 %) experienced no remission of T2DM. The mean serum triglyceride of 31 patients was statistically decreased after surgery compared to that before surgery (P < 0.05).
  
  
  
  This research shows that the GBP procedure is safe and effective for T2DM patients with BMI <28 kg/m2, and the condition of patients with HTG was greatly improved. However, further studies with larger samples and long-term follow-up are needed.
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China. gongke6688@yahoo.com.
authors.forename: Ke
authors.initials: K
authors.lastname: Gong
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China. nengweizhang@hotmail.com.
authors.forename: Nengwei
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China.
authors.forename: Dexiao
authors.initials: D
authors.lastname: Du
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China.
authors.forename: Dongdong
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Street, Yangfangdian Road, Haidian District, Beijing, 100038, China.
authors.forename: Jirun
authors.initials: J
authors.lastname: Peng
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss; D055815:Young Adult
chemical_list: D002096:C-Peptide; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007328:Insulin; D014280:Triglycerides
keywords: Laparoscopic surgery; Low body mass index; Roux-en-Y gastric bypass; Type 2 diabetes mellitus