Clinical Observation Of Laparoscopic Roux-en-Y Gastric Bypass In The Treatment Of Type 2 Diabetes Mellitus With Obese Patients

ObjectiveWith the change of lifestyle and diet structure,the prevalence of diabetes and obesity is increasing.Weight-loss surgery can greatly improve blood sugar control in obese patients with type 2 diabetes mellitus(T2DM),and some patients can even achieve diabetic remission.The purpose of this study was to observe the efficacy of laparoscopic Roux-en-Y gastric bypass(LRYGB)in the treatment of type 2 diabetes mellitus with obese patients.MethodsFrom October 2016 to February 2018,48 obese patients with type 2 diabetes mellitus in our hospital were studied.LRYGB was used for surgical treatment.The general conditions of operation time,hospitalization time and complications after operation were observed;body weight-related indicators before and after operation[body weight,body mass index(BMI),waist circumference,hip circumference,waist-hip ratio,percentage of weight loss(EBWL),body fat content and percentage in area A and G];blood sugar and fat metabolism-related indicators[fasting blood glucose(FPG),fasting insulin(FINS),fasting C-peptide(FCP),homeostasis model assessment of insulin resistance index(HOMA-IR),glycosylated hemoglobin(HbA1c),total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(HDL),uric acid and blood pressure.According to the criteria established by the American Diabetes Association,the therapeutic effect of T2DM was judged.According to the therapeutic effect,48 patients were divided into cure group and improvement or control group.Statistical analysis was performed by t test orc~2 test.Results1.The operation time of LRYGB was(73.32±17.64)minutes,and the hospitalization time was(2.45±0.80)days.There were 1 case of gastrointestinal anastomotic bleeding and 1 case of frequent diarrhea after operation.2.Six months after LRYGB,body weight,BMI,waist circumference,EBWL,body fat content in area A,percentage of body fat content in area A,percentage of body fat content in area G and percentage of body fat content in area G decreased significantly(P<0.05).There was no significant difference in A/G before and after treatment(P>0.05).3.Six months after LRYGB,FPG,FINS,FCP,HOMA-IR,HbA1C,TG,TC and LDL decreased significantly,while HDL increased significantly(P<0.05).4.Six months after LRYGB,uric acid,systolic blood pressure and diastolic blood pressure were significantly decreased(P<0.05).5.Twenty-seven patients(56.25%)were cured of T2DM,15 patients(31.25%)had their blood sugar controlled,and 6 patients(12.50%)had their blood sugar improved.The age,course and BMI of the treated group were lower than those of the improved or controlled group(P<0.05).Conclusion1.LRYGB is safe and effective in the treatment of obese patients with type 2diabetes mellitus.It can significantly improve the body weight and glycolipid metabolism of patients.2.Age,course of disease and BMI may affect the efficacy of LRYGB.