Aim: Sleeve gastrectomy (SG) and modified duodenal jejunal bypass (MDJB) were compared as procedures for glucose control. We aim to form the initial conclusions with respect to the possibility of (1) whether gastric fundus exclusion is essential for the control of diabetes and (2) application as a low morbidity procedure.
Materials and methods: SG and MDJB were performed on 10- to 12-week-old Goto-Kakizaki rats that spontaneously develop type 2 diabetes. Rats were observed for 36 weeks after surgery, and glucose, insulin, glucagons-like peptide-1 (GLP-1), glucose tolerate, insulin sensitivity, cholesterol, triglycerides, and free fatty acid levels were measured.
Results: Apart from distinct weight loss of SG and MDJB after 1 month compared with sham-operated rats (P < 0.001), SG showed strikingly improved blood glucose levels and significantly decreased Ghrelin secretion (P < 0.001). Furthermore, SG resulted in a shorter operative time (P < 0.01) and postoperative recovery time (P < 0.01) than MDJB group.
Conclusions: SG shows better control in terms of glucose tolerance and other measurements. This study provides direct evidence that SG possesses better improvement of diabetes by reduction of Ghrelin.