胃转流手术对超重2型糖尿病患者血糖影响因素分析

Effect of Gastric Bypass Surgery on Blood Glucose in Patients with Type 2 Diabetes Meilitus

【目的】观察胃转流手术影响超重2型糖尿病患者血糖是否与手术引起的体重减低有关。【方法】超重2型糖尿病患者饮食控制组（A组16例）和胃转流手术组（B组16例）。两组患者年龄，体重，身体质量指数，糖尿病病程和干预后体重减少无差异。B组术前及术后1个月，A组减重前及减重后分别口服75克葡萄糖测定空腹及2h血糖，胰岛素，C肽，胰高血糖素样肽（GLP）-1水平。比较两组之间的差异。【结果】与A组比较，B组空腹血糖及2h血糖降低，空腹及2hGLP-1增长。【结论】胃转流手术后，更多的GLP-1释放可能与降低血糖有关，而非单纯与手术引起的体重减少有关。

[Objective] To observe whether the effect of gastric bypass surgery（GBP）on glucose in patients with type 2 diabetes mellitus（T2DM） is correlated with weight loss caused by the surgery. [Methods] Thirty two patients with T2DM were randomly divided into diet control group （group A, n = 16） and GBP group（group B, n =16）. Patients from both groups were matched for age, body weight, body mass index, the course of diabetes and the degree of weight loss. The levels of fasting plasma glucose, and 2h blood glucose, insulin, C-peptide and glucagon-like peptide （GLP）-I were measured after orally taking 75g glucose in group A before and after weight relief. The difference between two groups was compared. [Results] Compared with group A, fasting plasma glucose and 2h blood glucose in group B decreased, and fasting- and 2h-GLP-1 increased. [Conclusion] After GBP, the increase of the release of GLP 1 may be related to the decrease of blood glucose, and not to weight loss.