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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2020

01-10-2020 | Insulins

Distal gastric mucosa ablation induces significant weight loss and improved glycemic control in type 2 diabetes Sprague–Dawley rat model

Authors: Ponnie Robertlee Dolo, Ke Huang, Jason Widjaja, Chao Li, Xiaocheng Zhu, Libin Yao, Jian Hong

Published in: Surgical Endoscopy | Issue 10/2020

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Abstract

Background

Excluding the foregut (distal stomach and duodenum) from food transit in RYGB normalizes glucose tolerance. Excluding/removing the duodenal mucosa partly improves glycemic control. So far, the effect of excluding/removing the gastric mucosa remains unknown.

Objective

To observe the effect of removing the distal gastric mucosa on glucose tolerance.

Method

Thirty fatty Sprague–Dawley rats received low-dose streptozotocin (STZ) to induce type 2 diabetes (T2D), then randomly assigned to Roux-en-Y gastric bypass (RYGB, n = 8), distal gastric mucosa removal (DGMR, n = 8), duodenal–jejunal bypass (DJB, n = 8), and Sham (n = 6) groups. In the DGMR group, the distal third of the gastric mucosa was removed by thermal ablation using an electrocautery. Rats were followed for 8 weeks postoperatively. Preoperative oral glucose tolerance test (OGTT), insulin tolerance test (ITT), and mixed-meal tolerance test (MMTT) were repeated 3 and 6 weeks postoperatively. Changes in body weight, food intake, and fasting blood glucose were also recorded.

Results

Gastrin AUC decreased significantly (p < 0.05) in the DGMR group after surgery. A significantly increased GLP-1 AUC was found in the RYGB, DGMR, and DJB groups at week 3 and only the RYGB group at week 6 postoperatively. The improved glucose tolerance in the RYGB group was significantly greater than the improved glucose tolerance in the DGMR and DJB groups. The improved glucose tolerance 3 and 6 weeks after surgery in the DGMR group was significantly greater than the improved glucose tolerance in the DJB group. Body weight decreased significantly in the RYGB, DGMR, and DJB groups postoperatively.

Conclusion

Removing the distal gastric mucosa induced significant weight loss and improved glycemic control in T2D SD rat model. Therefore, the gastric mucosa exclusion in RYGB may be key to the weight loss and diabetes remission, which perhaps warrants a new theory.
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Metadata
Title
Distal gastric mucosa ablation induces significant weight loss and improved glycemic control in type 2 diabetes Sprague–Dawley rat model
Authors
Ponnie Robertlee Dolo
Ke Huang
Jason Widjaja
Chao Li
Xiaocheng Zhu
Libin Yao
Jian Hong
Publication date
01-10-2020
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-07200-3

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