Ackerman N B
Surg Gynecol Obstet. 1981 May;152(5):581-6.
In most morbidly obese patients with diabetes, fasting plasma glucose levels decreased immediately after jejunoileal bypass operations, with patients often becoming normoglycemic before discharge from the hospital. All 12 patients who had required insulin or orally administered hypoglycemic agents preoperatively were able to discontinue the medication shortly after the operation. Oral glucose tolerance test curves in all morbidly obese patients had a flattened pattern, in the normal range, postoperatively. Serum insulin levels, which had been elevated preoperatively, decreased significantly, both in fasting and postglucose determinations. Results of intravenous glucose tolerance tests showed little change in the early period after operation. Improvement in carbohydrate metabolism may be due to several factors and does not appear to be dependent upon massive weight loss. Major factors may include decreased absorption of carbohydrates and amino acids, decreased oral caloric intake, increased insulin sensitivity and decreased output of gastric inhibitory polypeptide as well as the eventual weight loss.
在大多数患有糖尿病的病态肥胖患者中，空肠回肠分流术后空腹血糖水平立即下降，患者常在出院前血糖恢复正常。术前需要胰岛素或口服降糖药的所有12例患者在术后不久都能够停用药物。所有病态肥胖患者术后口服葡萄糖耐量试验曲线呈平坦型，处于正常范围内。术前升高的血清胰岛素水平在空腹及葡萄糖测定后均显著下降。静脉葡萄糖耐量试验结果显示术后早期变化不大。碳水化合物代谢的改善可能归因于几个因素，似乎并不依赖于大量体重减轻。主要因素可能包括碳水化合物和氨基酸吸收减少、口服热量摄入减少、胰岛素敏感性增加、胃抑制多肽分泌减少以及最终的体重减轻。
