Putting the Hindgut Hypothesis to the Test in a Diabetic Zucker Rat Model

Reverse Transposition - a New Surgical Model for the Study the Role of Ileum in Glucose Metabolism

We studied the possibility of reverse transposition of the small intestine and its effect on glucose metabolism. The reverse transposition model proposed by us consists in a 180° turn of the small intestine after transection and antiperistaltic transposition of the entire intestinal tube. To this end, outbred white rats underwent reverse transposition of the small intestine, sham-operated rats served as the control. Both groups were monitored for body weight and blood glucose levels at fast and after oral glucose tolerance test. The groups did not differ by the duration of surgery, body weight, and blood glucose levels at fast and after glucose tolerance test. The reverse transposition technique proposed by us is reproducible, the anatomical changes lead to early contact of the chyme with the terminal portion of the small intestine, which can modulate absorption of nutrients and the release of ileal hormones (incretins) affecting glucose metabolism.

Improvement of Diabetes Mellitus After Colorectal Cancer Surgery: A Retrospective Study of Predictive Factors For Type 2 Diabetes Mellitus Remission and Overall Survival

PURPOSE

The purpose of the current study was to evaluate the impact of colorectal cancer (CRC) surgery on type 2 diabetes mellitus (T2DM) and to analyze the change in T2DM on overall survival after CRC surgery.

METHODS

Patients who underwent CRC surgery were retrospectively enrolled from January 2013 to December 2019. The status of T2DM pre- and 1-year after CRC surgery was recorded, and predictive factors for T2DM remission and overall survival were analyzed.

RESULTS

A total of 296 patients were included in this study. Thirty-eight patients experienced remission of T2DM 1 year after CRC surgery, and the remission rate was 12.8%. Weight loss was significantly higher in the T2DM remission group (p = 0.038), and the T2DM duration was significantly shorter in the T2DM remission group (p = 0.015). In the multivariate logistic regression analysis, higher weight loss (p = 0.046, odds ratio = 1.060, 95% CI = 1.001-1.122) and shorter T2DM duration (p = 0.019, odds ratio = 1007, 95% CI = 1.001-1.014) were predictive factors for remission of T2DM. Furthermore, in multivariate Cox regression analysis, lower TNM stage (p = 0.000, odds ratio = 2.147, 95% CI = 1.474-3.128) and T2DM remission (p = 0.033, odds ratio = 2.999, 95% CI = 1.091-8.243) were the predictive factors for better overall survival.

CONCLUSION

Patients with concurrent CRC and T2DM had a 12.8% remission 1 year after CRC surgery. Higher weight loss and shorter T2DM duration contributed to T2DM remission, and patients with T2DM remission could improve in terms of their overall survival.