Effect of weight loss by diet or gastric bypass surgery on peptide YY3-36 levels. Ann Surg. 2009;249:948-953. [PMID: 19474685 DOI: 10.1097/SLA.Ob013e3181a6cdbo]

Effect of laparoscopic Roux-en-Y gastric bypass on glucose metabolism in obese patients with type 2 diabetes mellitus

AIM: To investigate the effect of laparoscopic Roux-en-Y gastric bypass (LRYGB) on glucose metabolism in obese patients with type 2 diabetes mellitus.

METHODS: Twenty obese patients with type 2 diabetes mellitus underwent LRYGB. Fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h PBG), C peptide (C-P), glycosylated hemoglobin (HbA1C) and fasting insulin (Fins) were recorded before surgery and at the 1^st, 4^th, 8^th, 12^th, and 24^th week after surgery. Insulin resistance index (HOMA-IR) was calculated and compared.

RESULTS: LRYGB was successful in all the patients, without intraoperative complications or conversion to open surgery. FBG decreased from 11.25 mmol/L ± 3.36 mmol/L before surgery to 6.21 mmol/L ± 0.52 mmol/L at the 24^th week after surgery (P < 0.05), 2 h PBG from 15.33 mmol/L ± 2.54 mmol/L to 8.78 mmol/L ± 1.51 mmol/L (P < 0.05), HbA1C from 9.05% ± 1.27% to 6.53% ± 0.58% (P < 0.05), HOMA-IR from 7.16 ± 0.65 to 3.84 ± 0.47 (P < 0.05), and Fins increased from 11.24 mU/L ± 0.98 mU/L to 12.03 mU/L ± 0.75 mU/L (P > 0.05). The total effective rate was 100%, the recovery rate was 85%, and the improvement rate was 15%.

CONCLUSION: LRYGB can significantly reduce plasma glucose levels and improve glucose metabolism in obese patients with type 2 diabetes mellitus.