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It has been confirmed clearly that gastric bypass operation could be used for tbe treatment of type 2 diabetes mellitus.However,the curative mechanism underlying this therapy remain unclear up to now.Referencing the curative mechanisms research progress from domestic and abroad,the possible mechanism is considered as the secretion of gastrointestinal hormones can be changed after gastric by~ss operation,which has altered the normal anatomy structure of the gastrointestinal,and so as to the situation of type 2 diabetes mellitus can be controlled.This review will summarize recent papers related to mechanism research about the gastric bypass operatiou for the treatment of type 2 diabetes mellitus.
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Objective To study the mechanism of gastric bypass operation on treatment of type 2 diabetes mellitus,recognize the etiology and pathogenesy of the disease and frame therapy strategy for type 2 diabetes mellitus.Methods The literatures about gastric bypass operation on treatment of type 2 diabetes mellitus,including clinical cases reports and evidence-based studies were reviewed.Results Gastrointestinal bypass operation was regarded as an effective treatment for type 2 diabetes mellitus.There were three hypotheses of therapy mechanism: early delivery of nutrients to the distal intestine,exclusion of the proximal intestine and incretin/anti-incretin.Conclusion Gastrointestinal bypass operation is now considering as an effective treatment,there is still a lack of basic experimental studies to clarify the mechanism.
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Objective To observe the curative effect on non-obese type 2 diabetes and the effect on change of glucagon-like peptide-1 (GLP-1) of gastric bypass operation. Methods Thirty-two cases of gastric ulcer with non-obese type 2 diabetes were suffered gastric bypass operation. Plasma glucose concentrations, insulin and GLP-1 were measured respectively in fasting and postprandial conditions before operation and in week 1, 2, 3 and month 1, 3, 6 after gastric bypass operation, and the body mass index (BMI), homeostasis model assessment ? cell function index (HBCI) and glycosylated hemoglobin (HbA1c, the index was detected only before operation and in month 3, 6 after operation) were also measured. The turnover of the diabetes condition in the 6th month after surgery was observed. Results Compared with the levels before operation, the fasting and postprandial plasma glucose levels were descending (P0.05). The diabetes control rate was 78.1%(25/32) overall six months after operation. Level of GLP-1 was negatively correlated with level of plasma glucose (P
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0.05);one week after surgery,the fasting blood glucose level showed a sustained and steady downward trend(P0.05).Conclusions Gastric bypass operation has a good therapeutic effect on type 2 diabetes in the non-obese patients,and this therapeutic effect is not dependent on loss of body weight.