Improvement of type 2 diabetes mellitus after gastric cancer surgery: short-term outcome analysis after gastrectomy.

Abstract

AIM: To evaluate the effect of gastrectomy on diabetes control in patients with type 2 diabetes mellitus and early gastric cancer. METHODS: Data from 64 patients with early gastric cancer and type 2 diabetes mellitus were prospectively collected. All patients underwent curative gastrectomy (36 subtotal gastrectomy with gastroduodenostomy, 16 subtotal gastrectomy with gastrojejunostomy, 12 total gastrectomy) and their physical and laboratory data were evaluated before and 3, 6 and 12 mo after surgery. RESULTS: Fasting blood glucose (FBS), HbA1c, insulin, C-peptide, and homeostasis model assessment-estimated insulin resistance were significantly improved 3 mo after surgery, regardless of operation type, and the significant improvement in all measured values, except HbA1c, was sustained up to 12 mo postoperatively. Approximately 3.1% of patients stopped diabetes medication and had HbA1c < 6.0% and FBS < 126 mg/dL. 54.7% of patients decreased their medication, and had reduced FBS or HbA1c. In multivariate analysis, good diabetic control was not associated with operation type, but was associated with diabetes duration. CONCLUSION: Diabetes improved in more than 50% of patients during the first year after gastric cancer surgery. The degree of diabetes control was related to diabetes duration.