Does Roux-en-Y gastrectomy for gastric cancer influence glucose homeostasis in lean patients?

Hayashi, Silvia Yoko; Faintuch, Joel; Yagi, Osmar Kenji; Yamaguchi, Camila M.; Faintuch, Jacob J.; Cecconello, Ivan

doi:10.1007/s00464-013-2829-3

Cited by 9 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, our finding was similar to that of a previous report, which found that 37.5% of lean patients with GC had improved glucose metabolism [11]. The low rate of DM remission in the patients with GC after TG may be associated with (1) less enteral bypass, (2) relatively lean body composition of patients with GC compared with morbidly obese ones, and 3) further anticancer therapy affecting glucose metabolism in post-TG cases.…”

Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 98%

“…However, gastrectomy has been associated with postprandial hyperglycemia and impaired insulin response in the early postgastrectomy period [11,12]. Furthermore, some patients developed alimentary hyperglycemia, which was associated with the decrease in insulin secretion [13], whereas DM did not resolve or improve even after TG for other patients [14].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Total gastrectomy improves glucose metabolism on gastric cancer patients: a nationwide population-based study

Yang

et al. 2016

Surgery for Obesity and Related Diseases

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 98%

See 1 more Smart Citation

Total gastrectomy improves glucose metabolism on gastric cancer patients: a nationwide population-based study

Yang

et al. 2016

Surgery for Obesity and Related Diseases

View full text Add to dashboard Cite

“…Gastrectomy to treat gastric cancer is technically similar to bariatric surgery; therefore, it was expected to have metabolic benefits in gastric cancer patients with T2DM. Several studies have discussed improvement in glycemic control and weight reduction after gastrectomy in gastric cancer patients [15][16][17][18]28,29]. However, no studies have compared gastrectomy to non-surgical treatment in gastric cancer patients, except for our previous epidemiological study [18].…”

Section: Discussionmentioning

confidence: 97%

Metabolic Effects of Gastrectomy and Duodenal Bypass in Early Gastric Cancer Patients with T2DM: A Prospective Single-Center Cohort Study

Lee

et al. 2021

JCM

View full text Add to dashboard Cite

We evaluated the metabolic effects of gastrectomies and endoscopic submucosal dissections (ESDs) in early gastric cancer (EGC) patients with type 2 diabetes mellitus (T2DM). Forty-one EGC patients with T2DM undergoing gastrectomy or ESD were prospectively evaluated. Metabolic parameters in the patients who underwent gastrectomy with and without a duodenal bypass (groups 1 and 2, n = 24 and n = 5, respectively) were compared with those in patients who underwent ESD (control, n = 12). After 1 year, the proportions of improved/equivocal/worsened glycemic control were 62.5%/29.2%/8.3% in group 1, 40.0%/60.0%/0.0% in group 2, and 16.7%/50.0%/33.3% in the controls, respectively (p = 0.046). The multivariable ordered logistic regression analysis results showed that both groups had better 1-year glycemic control. Groups 1 and 2 showed a significant reduction in postprandial glucose (−97.9 and −67.8 mg/dL), body mass index (−2.1 and −2.3 kg/m2), and glycosylated hemoglobin (group 1 only, −0.5% point) (all p < 0.05). Furthermore, improvements in group 1 were more prominent when preoperative leptin levels were high (p for interaction < 0.05). Metabolic improvements in both groups were also observed for insulin resistance, leptin, plasminogen activator inhibitor-1, and resistin. Gastrectomy improved glycemic control and various metabolic parameters in EGC patients with T2DM. Patients with high leptin levels may experience greater metabolic benefits from gastrectomy with duodenal bypass.

show abstract

“…Finally, Hayashi SY et al . reported a high rate of refractory cases in diabetic and gastric cancer patients, and also high rate of new-onset diabetes cases in non-diabetic and gastric cancer patients, following roux-en-y gastrectomy 21 . Our study similarly demonstrated that EDNG (total gastrectomy) resulted in lower insulin, higher glucagon and subsequently inferior glucose control level when compared to EDG (bypassed and preserved stomach).…”

Section: Discussionmentioning

confidence: 99%

Bypassed and Preserved Stomach Resulted in Superior Glucose Control in Sprague-Dawley Rats with Streptozotocin-Induced Diabetes

Widjaja

Dolo

Zhang

et al. 2019

Sci Rep

View full text Add to dashboard Cite

Recent studies suggest the possibility of the stomach playing a role in diabetes remission after bariatric surgery. In this study, we investigated whether bypassing the stomach alleviates diabetes in diabetic rodent model. Eighteen moderately obese and diabetic Sprague-Dawley rats were randomly assigned to Esophagoduodenostomy with or without gastric preservation (EDG and EDNG/total gastrectomy, respectively), and SHAM groups. Bodyweight, food intake, fasting glucose level, oral glucose tolerance test result (OGTT), and hormone levels (insulin, glucagon-like peptide-1, ghrelin, gastrin and glucagon) were measured preoperative and postoperatively. Postoperatively, bodyweight and food intake did not differ significantly between the EDG and EDNG groups. Postoperative fasting blood glucose and OGTT results declined significantly in the EDG and EDNG group when compared with the respective preoperative levels. Postoperative glucose control improvements in EDNG group was significantly inferior when compared to EDG. Compared preoperatively, postoperative plasma ghrelin and gastrin levels declined significantly in EDNG group. Preoperative and postoperative plasma GLP-1 level did not differ significantly among all the groups. Postoperatively, EDG group had significantly higher insulin and lower glucagon levels when compared with SHAM. In conclusion, bypassing and preserving the stomach resulted in superior glucose control improvements than total gastrectomy.

show abstract

Does Roux-en-Y gastrectomy for gastric cancer influence glucose homeostasis in lean patients?

Abstract: Diabetes response was confirmed, however with more refractory cases than in bariatric controls, whereas high proportions of NOD occurred. Such dichotomous pattern seems unusual albeit consistent with previous studies.

Cited by 9 publications

References 20 publications

Total gastrectomy improves glucose metabolism on gastric cancer patients: a nationwide population-based study

Total gastrectomy improves glucose metabolism on gastric cancer patients: a nationwide population-based study

Metabolic Effects of Gastrectomy and Duodenal Bypass in Early Gastric Cancer Patients with T2DM: A Prospective Single-Center Cohort Study

Bypassed and Preserved Stomach Resulted in Superior Glucose Control in Sprague-Dawley Rats with Streptozotocin-Induced Diabetes

Contact Info

Product

Resources

About