Effects of Subtotal Gastrectomy and Roux-en-Y Gastrojejunostomy on the Clinical Outcome of Type 2 Diabetes Mellitus

Background: To investigate the effects of subtotal gastrectomy and Roux-en-Y gastrojejunostomy on the clinical outcome of patients with type 2 diabetes mellitus (T2DM).

Methods: We performed retrospective analysis of 21 patients with T2DM operated due to stomach cancer and upper gastrointestinal tract ulcer between January 2001 and June 2008.

Results: The body mass index (BMl) of all patients was <30 kg/m(2). The mean postoperative follow-up period was 26.6 mo (range, 6 mo-5 y). Subtotal gastrectomy and Roux-en-Y gastrojejunostomy remarkably lowered the levels of fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG), and glycated hemoglobin (HbA1c). Overall, 12 patients (57.1%) achieved adequate glycemic control (HbA1c < 7%) without antidiabetic medication and five patients (23.8%) showed good improvement. The total effectiveness rate of the surgery in T2DM patients was 81.0%.

Conclusion: Subtotal gastrectomy and Roux-en-Y gastrojejunostomy appear to be effective treatment modalities for controlling T2DM in patients with BMl <30 kg/m(2). However, more studies with long follow-up period and large number of patients are necessary to clarify the benefits of this procedure.