Effect of subtotal gastrectomy on glucose metabolism in patients with gastric disease combined with diabetes mellitus

Objective To investigate the effect of subtotal gastrectomy on glucose metabolism in patients with gastric disease combined with diabetes mellitus.Methods The clinical data of 126 cases with gastric disease combined with diabetes mellitus receiving subtotal gastrectomy were analyzed retrospectively,including subtotal gastrectomy Billroth Ⅱ type 69 patients (Billroth Ⅱ type group),subtotal gastrectomy Billroth Ⅰ type 57 patients (Billroth Ⅰ type group).The fasting blood glucose,postprandial blood glucose before surgery and 1,3,6 months after surgery and the improvement of glucose metabolism were compared.Results There was no significant difference in the fasting blood glucose,postprandial blood glucose before surgery and 1,3,6 months after surgery in Billroth Ⅰ type group (P ＞0.05).The fasting blood glucose,postprandial blood glucose 3,6 months after surgery [ (10.7 ±2.9 ),(10.4 ± 2.3 ) mmol/L and (12.4 ± 2.6),(12.0 ±3.2) mmol/L] were higher than those before surgery and 1 month after surgery [(14.1 ±3.2),(13.4 ±3.8) mmol/L and (19.0 ±3.9),(18.1 ±4.3) mmol/L] in Billroth Ⅱ type group with significant differences (P ＜ 0.05 or ＜ 0.01 ).The improving rate of glucose metabolism in Billroth Ⅰ type group [ 7.02％(4/57) ] was lower than that in Billroth Ⅱ type group [ 92.75％(64/69)] with significant difference(P ＜ 0.01 ).Conclusions Subtotal gastrectomy has obvious effect on improving glucose metabolism in patients with gastric disease combined with diabetes mellitus.The use of subtotal gastrectomy Billroth Ⅱ type is prior to subtotal gastrectomy Billroth Ⅰ type. Key words: Gastrectomy; Stomach diseases; Diabetes mellitus; Blood glucose; Insulin