Changes in insulin resistance after ileoduodenoplasty performing

Abstract

The aim of the work: to analyze own experience of IR changes in the course of performing metabolic correction in original way of ileac shift by stomach with duodenum exclusion from food passage. Materials and Methods. Insulin resistance (IR) was studied in 15 patients with body mass index (BMI) within 20.3–58.3 kg/m2. Surgery consists of ileoduodenoplasty (IDP) performing by the way of duodenal and ileac transection and ileac shift by stomach with duodenum exclusion from food passage. In all patients fasting blood glucose, insulin and c-peptide levels were measured before surgery and 7–21 days by surgery. According to blood level of insulin and c-peptide before surgery all cases may be differentiated into three groups. Results and Discussion. Three weeks after surgery only in four patients of group 1 insulin content was on the upper level of norm or slightly higher of it while became, respectively, 59.1 %, and 32.8 %, and 42.2 %, and 34.7  % from preoperative indication. In two patients of group 2 insulin level falls into the range of norm, while in one it left slightly higher of those and, respectively, became 49.7 %, 34.7 %, and 21.0 % from those of pre-operation. Three patients (group 3) with insulin level withing normal range while c-peptide level was higher than range of norm. It is not understandable at the time why c-peptide level at three weeks after surgery changes differently in all groups. In all cases IR, which was regarded as higher than normal insulin or c-peptide level, disappear within three weeks after surgery. Obtained data elucidate the difference in the IR origin. It is of interest the similar level of insulin in IR despite different concentration of c-peptide. Also, it is of interest elevation of c-peptide level after surgery while IR disappear. Reasons of such reaction need further research.