Long-term follow-up for type 2 diabetes mellitus after gastrectomy in non-morbidly obese patients with gastric cancer: The legitimacy of onco-metabolic surgery

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Abstract

Purpose: This study primarily aimed to investigate the short-and long-term remission rates of type 2 diabetes (T2D) in patients who underwent surgical treatment for gastric cancer, especially patients who were non-obese, and secondarily to determine the potential factors associated with remission. Materials and Methods: We retrospectively reviewed the clinical records of patients with T2D who underwent radical gastrectomy for gastric cancer, from January 2008 to December 2012. Results: T2D improved in 39 out of 70 (55.7%) patients at the postoperative 2-year follow-up and 21 of 42 (50.0%) at the 5-year follow-up. In the 2-year data analysis, preoperative body mass index (BMI) (P=0.043), glycated hemoglobin (A1C) level (P=0.039), number of anti-diabetic medications at baseline (P=0.040), reconstruction method (statistical difference was noted between Roux-en-Y reconstruction and Billroth I; P=0.035) were significantly related to the improvement in glycemic control. Unlike the results at 2 years, the 5-year data analysis revealed that only preoperative BMI (P=0.043) and A1C level (P=0.039) were statistically significant for the improvement in glycemic control; however, the reconstruction method was not. Conclusions: All types of gastric cancer surgery can be effective in short-and long-term T2D control in non-obese patients. In addition, unless long-limb bypass is considered in gastric cancer surgery, the long-term glycemic control is not expected to be different between the reconstruction methods.

Original languageEnglish
Pages (from-to)283-294
Number of pages12
JournalJournal of Gastric Cancer
Volume17
Issue number4
DOIs
Publication statusPublished - 2017 Dec 1

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Keywords

  • Control
  • Glycemic index
  • Reconstruction method
  • Stomach neoplasms
  • Surgery
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

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