Key result
Sleeve gastrectomy with modified jejunoileal bypass improved oral glucose tolerance, insulin tolerance, and GLP-1 secretion compared to sleeve gastrectomy alone at 16 weeks in diabetic rats.
Why the study?
Does sleeve gastrectomy with modified jejunoileal bypass improve glycemic control compared to sleeve gastrectomy alone or sham operation in a non-obese diabetic rat model?
RCT (n=35)
randomly assigned
Does sleeve gastrectomy with modified jejunoileal bypass improve glycemic control compared to sleeve gastrectomy alone or sham operation in a non-obese diabetic rat model?
In a non-obese diabetic rat model, sleeve gastrectomy with modified jejunoileal bypass provided superior glycemic control and GLP-1 secretion compared to sleeve gastrectomy alone.
SG/MJIB model supports glycemic control in diabetic rats; leaves open translation to human bariatric surgery.
PURPOSE: To develop a non-obese diabetic rat model for sleeve gastrectomy with modified jejunoileal bypass (SG/MJIB) and to investigate its effectiveness and safety for inducing diabetic control. MATERIALS AND METHODS: Thirty-five 13-week-old male Goto-Kakizaki rats were randomly assigned to the pair-fed to sham-operated SG/MJIB (PFSO-SG/MJIB), SG/MJIB, PFSO-SG, SG, and control groups. The experimental period was 16 weeks post-operatively. Body weight; food intake; glycemic control outcomes; and ghrelin, glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and insulin levels were measured. RESULTS: The operated and PFSO groups showed significant weight loss 4 weeks post-operatively compared to the control. The SG/MJIB and SG groups exhibited a significant improvement in oral glucose tolerance and insulin tolerance compared to the PFSO and control groups. The improved effects in the SG/MJIB group were better than those in the SG group. The SG/MJIB and SG groups showed decreased fasting ghrelin levels and increased levels of GLP-1 secretion 2 and 16 weeks post-operatively. Compared to the SG group, only the SG/MJIB group showed higher glucose-stimulated GLP-1 levels and significantly improved insulin secretion. CONCLUSION: SG/MJIB may be an effective, steady hypoglycemic surgical model, showing better diabetic control than SG. The hindgut may play a direct role in ameliorating glucose homeostasis.
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Zhu et al. (2015) conducted an RCT in Diabetes (n=35). Sleeve gastrectomy with modified jejunoileal bypass (SG/MJIB) vs. Sham-operated, sleeve gastrectomy alone, and control groups was evaluated on Body weight, food intake, glycemic control outcomes, and hormone levels. Sleeve gastrectomy with modified jejunoileal bypass improved oral glucose tolerance, insulin tolerance, and GLP-1 secretion compared to sleeve gastrectomy alone at 16 weeks in diabetic rats.
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