Summary:
Type 2 diabetic obese patients present with a normalization of plasma glucose
levels shortly after most bariatric procedures, before any significant weight
loss takes place. There is only scarce literature in the new field of metabolic
surgery, with most experiments being performed on small animal models. To our
best knowledge this study is the first to assess the effects of gastric bypass
in the larger porcine STZ-induced diabetic model.
Titrated doses of streptozotocin (STZ) were used for induction of diabetes
mellitus. After standardization of the surgical technique to avoid any
restrictive component, three groups were created, a duodenojejunal bypass (DJB;
n=4), a gastroileal conduit near the ileocecal valve (GIC; n=3) and a sham
(Control) group (n=5). Preoperative and postoperative glycemic curves were
recorded by means of intravenous glucose tolerance tests, as well as body
weight fluctuations.
Diabetes was successfully induced with the use of STZ. Animals in the sham
group remained diabetic for 3 weeks after operation. There was normalization of
blood glucose levels in the operative groups during the 3-week postoperative
follow up, without significant body weight changes. The duodenojejunal group
resulted in stronger positive response of glycemia.
STZ is an effective but highly toxic means for inducing stable diabetes in the
sensitive porcine model. Duodenojejunal bypass, although less invasive, seems
to exert better antidiabetic effects than gastroileal conduit.
Keywords:
Metabolic surgery, Diabetes mellitus type 2, Gastric bypass, Duodenojejunal bypass, Porcine diabetic model
