Does Colectomy Improve Type 2 Diabetes?
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Does Colectomy Improve Type 2 Diabetes? Suriya Punchai 1,2 & Rickesha L Wilson 1 & Katherine M Meister 1,3 & Zubaidah Nor Hanipah 1,4 & Roman Vangoitsenhoven 1,5 & Philip R Schauer 6 & Scott R Steele 7 & Tracy L Hull 7 & Ali Aminian 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Gastrectomy and gastric bypass improve type 2 diabetes (T2DM), potentially through alterations in intestinal hormones and the microbiome. The aim of this study was to analyze whether colorectal resections result in improvement of T2DM. A total of 171 patients with T2DM who underwent colectomy for benign diseases were studied with a median postoperative follow-up of 3 years (interquartile range [IQR] 1–5). The median BMI and glycated hemoglobin (HbA1c) at baseline and post-colectomy were 30.3 kg/m2 (IQR 26.6–34.6) versus 30.4 kg/m2 (IQR 26.2–35) (p = 0.1), and 6.7% (IQR 6.2–7.5) versus 6.5% (IQR 6.5–7.1) (p = 0.5), respectively. The proportion of patients taking diabetes medications at baseline versus post-colectomy did not differ significantly. Changes in BMI, HbA1c, and status of diabetes medications were not statistically different between the subtypes of colorectal resection. Our experience suggests that colectomy for benign colorectal diseases is not associated with long-term changes in body weight or glycemic control. Keywords Colorectal disease . Body weight . Colectomy . Type 2 diabetes mellitus . Bariatric . Weight loss
Introduction The prevalence of obesity and type 2 diabetes mellitus (T2DM) is increasing worldwide. The powerful impact of bariatric surgery on obesity, glycemic control, and a host of other chronic conditions by altering gastrointestinal anatomy and physiology highlights the metabolic impact of these procedures [1, 2]. The mechanisms underlying metabolic * Ali Aminian [email protected] 1
Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, 9500 Euclid Avenue, Desk M61, Cleveland, OH 44195, USA
2
Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
3
Department of General Surgery, Good Samaritan Hospital, TriHealth, Cincinnati, OH, USA
4
Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Selangor, Malaysia
5
Department of Endocrinology, UZ Leuven, Leuven, Belgium
6
Bariatric and Metabolic Institute, Pennington Biomedical Research Center, Baton Rouge, LA, USA
7
Department of Colorectal Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
improvement following bariatric surgery, which are mainly foregut surgical procedures, have been postulated to include weight loss, and changes in gut hormones, intestinal glucose transport and utilization, bile acid signaling, and gut microbiome community [3]. The colon and rectum contain more than 90% of all gastrointestinal bacteria. Therefore, resection of the colon or rectum has the potential to significantly alter the intestinal microbiome and induce gastrointes
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