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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Illegitimacy
Bariatric Surgery
Gastrectomy
Type 2 Diabetes Mellitus
Stomach Neoplasms
Body Mass Index
Gastroenterostomy
Glycosylated Hemoglobin A
Extremities

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

@article{09748fd7d35e447fb6bb79099ecea016,
title = "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",
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.",
keywords = "Control, Glycemic index, Reconstruction method, Stomach neoplasms, Surgery, Type 2 diabetes mellitus",
author = "Lee, {Tae Hoon} and Lee, {Chang Min} and Sungsoo Park and Jung, {Do Hyun} and You-Jin Jang and Kim, {Jong Han} and Seong-Heum Park and Mok, {Young Jae}",
year = "2017",
month = "12",
day = "1",
doi = "10.5230/jgc.2017.17.e34",
language = "English",
volume = "17",
pages = "283--294",
journal = "Journal of Gastric Cancer",
issn = "2093-582X",
publisher = "Korean Gastric Cancer Association",
number = "4",

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TY - JOUR

T1 - Long-term follow-up for type 2 diabetes mellitus after gastrectomy in non-morbidly obese patients with gastric cancer

T2 - The legitimacy of onco-metabolic surgery

AU - Lee, Tae Hoon

AU - Lee, Chang Min

AU - Park, Sungsoo

AU - Jung, Do Hyun

AU - Jang, You-Jin

AU - Kim, Jong Han

AU - Park, Seong-Heum

AU - Mok, Young Jae

PY - 2017/12/1

Y1 - 2017/12/1

N2 - 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.

AB - 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.

KW - Control

KW - Glycemic index

KW - Reconstruction method

KW - Stomach neoplasms

KW - Surgery

KW - Type 2 diabetes mellitus

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U2 - 10.5230/jgc.2017.17.e34

DO - 10.5230/jgc.2017.17.e34

M3 - Article

AN - SCOPUS:85040790683

VL - 17

SP - 283

EP - 294

JO - Journal of Gastric Cancer

JF - Journal of Gastric Cancer

SN - 2093-582X

IS - 4

ER -