Impact of sub-gastrectomy on glucose regulation in gastric cancer patients with T2DM: a follow-up study

This study aims to investigate the changing characteristics of glucose regulation after gastric surgery for normal gastric cancer patients with type 2 diabetes mellitus (T2DM) (T2DM group) and without T2DM (normal group) in a tertiary hospital located in western China. We conducted a case-control study which retrospectively collected the data of 73 patients: (1) diagnosed as gastric cancer, (2) underwent sub-gastrectomy and Billroth II gastrointestinal anastomosis between October 2007 and December 2012, and (3) did not suffer a recurrent cancer and with sufficient clinical data. Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), insulin sensitive index (HOMA-IS), insulin resistance index (HOMA-IR), and beta cell function index (HOMA-BCF) were compared at baseline and postoperative 7, 14, 28, 56, 120, and 356 days. Baseline FBG, HbA1c, HOMA-IS, HOMA-IR, and HOMA-BCF in the T2DM group were significantly higher than those in the normal group. Immediate postoperative glucose changed significantly, and it became stable and normal during follow-up period in both the T2DM and normal group that there was no significance anymore after postoperative 28 days between them. Normal patients with T2DM would benefit from gastric surgery in glucose control, and it may involve not only decreased food intake and weight loss but also gastrointestinal reconstruction.