ABSTRACT
Objective To explore the influence of oral administration of glucose before surgery on insulin resistance and oxidative stress in castric cancer patients undergoing surgery.Methods 63 cases of castric cancer patients undergoing surgery were divided into observation group (n=32) and the control group (n=31) according to random number table method.Patients were given fasting after ten o'clock the day before surgery.Patients in the observation group were dealed with 500 ml 100 g/L glucose solution orally,while patients in the control group were dealed with the same amount of distilled water 3 hours before surgery.The general information and operation indicators were recorded.Blood glucose (GLU),insulin,malondialdehyde (MDA) and superoxide dismutase (SOD) levels were detected before surgery and 4 hours after surgery.Insulin resistance index(HOMAIR) was recorded also.Results The general data between the two groups before the test started had no statistically significant difference (P＞0.05).All patients completed test successfully,and the complications such as choking cough,aspiration did not happen during the treatment.The operation time,Intraoperative fluid infusion,intraoperative blood loss and postoperative pathological stage between the two groups had no statistical difference (P＞0.05).GLU,insulin and HOMA-IR in the two groups after surgery increased significantly than those before surgery,and the difference had statistical significance (P＜0.05).GLU,insulin and HOMA-IR were significantly lower in the observation group than in the control group,and the difference had statistical significance (P＜0.05).SOD and MDA in the two groups after surgery increased significantly than those before surgery,and the difference had statistical significance (P＜0.05).SOD in the observation group was significantly higher,while MDA was significantly lower than those in the control group,and the difference had statistically significance(P＜0.05).Conclusion Oral administration of glucose before surgery in castric cancer patients undergoing surgery can reduce insulin resistance and oxidative stress,and it is safe.
ABSTRACT
Objective To analyze the influence of different digestive tract reconstruction methods on blood sugar in T2DM patients after subtotal gastrectomy,and to explore the possible mechanism.Methods The clinical data of 64 cases of T2DM patients undergoing subtotal gastrectomy because of gastric ulcer or cancer were retrospectively analyzed.They were divided into Roux-en-Y group (34 cases) and Billroth Ⅱ group (30 cases) according to the different reconstruction methods of digestive tract,and they were treated by Roux-en-Y anasto-mosis and Billroth Ⅱ anastomosis respectively after subtotal gastrectomy.They were followed up for 6 months.BMI,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,insulin resistance index (HOMA-IR),glucagon peptide 1 (GLP-1),gastric inhibitory peptides (GIP),and GIP/GLP-1 before surgery and one week,one month,3 months,and 6 months after surgery were compared between the two groups.Results BMI of the two groups 3 months,and 6 months after surgery was significantly lower than those before surgery (P＜0.05),and it had no statistical significance between the two groups at the same time point (P＞0.05).Compared with preoperative,the fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,HOMA-IR one week,one month,3 months,and 6 months after surgery in the two groups were significantly lower than those before surgery (P＜0.05).The fasting blood sugar,and 2 h postprandial blood glucose were lower in Roux-en-Y group than in Billroth Ⅱ group (P＜0.05).The glycosylated hemoglobin in Roux-en-Y group was lower than those in Billroth Ⅱ group at 3 months,and 6 months after surgery (P＜0.05).Compared with those before surgery,GIP and GIP/GLP-1 in the two groups at one week,one month,3 months,and 6 months were significantly decreased after operation (P＜0.05).Also,they were significantly lower in Roux-en-Y group compared with Billroth Ⅱ group at the same time point.Conclusion Roux-en-Y anastomosis after subtotal gastrectomy may be more beneficial?for reducing blood glucose in T2DM patients,which may be more beneficial for keeping the balance of entero-insular axis.