Long Term Diabetes Improvement After Cancer Gastrectomy and Colectomy

Study Overview
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Brief Summary
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There is evidence that gastrointestinal operations for non weight-losing purposes are beneficial for diabetes mellitus. Aiming to analyze such hypothesis, patients submitted to gastric bypass for morbid obesity, gastrectomy for gastric cancer and colectomy for colo-rectal cancer will be compared. The end point will be changes in fasting blood glucose and hemoglobin A1c concentration.

Detailed Description
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In a prospective protocol with retrospective information, patients (N=240) undergoing bariatric Roux-en-Y gastric bypass (n=80), cancer subtotal or total gastrectomy (n=80) and right colectomy or rectosigmoidectomy (n=80) with follow-up >3 years free of disease, with or without previously impaired fasting blood glucose, will be recruited. Patients will be submitted to a questionnaire involving diet, diagnosis of diabetes and glucose-lowering drugs, body weight and other clinical items. Preoperative information available in the hospital system will be completed and current findings will be updated, including body mass index and biochemical measurements. Using the outcomes of the bariatric population as benchmark, both concerning diabetics that were ameliorated and nondiabetics that progressed to new-onset diabetes,results in the other groups will be compared. The study should answer whether gastric and colorectal surgery for cancer 1) Are beneficial for established diabetes; 2) Attenuate the conversion of normal patients to diabetes, both within a follow-up period of 3- 12 years;

Official Title
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Long Term Diabetes Improvement After Cancer Gastrectomy and Colectomy

Conditions
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Diabetes Mellitus, Prediabetes, Morbid Obesity, Gastric Cancer, Colorectal Cancer

Intervention / Treatment
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* Other: Interview, questionnaire, updated biochemical tests


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Follow-up period > 3 years, weight stable in the last year Exclusion Criteria: Reoperation or take-down of original operation, consumptive diseases, protein-calorie malnutrition, organ failures, pancreatic surgery, cell or organ transplantation, type 1 diabetes, cognitive impairment or Alzheimer disease, refusal to participate in the protocol

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cancer gastrectomy<br>Patients previously submitted to partial/total gastrectomy for gastric cancer | Other: Interview, questionnaire, updated biochemical tests<br>* Patients will be interviewed and questioned about nutritional status, diet, drugs and diagnosis/clinical course of diabetes. Routine biochemical tests will be searched and if necessary updated.<br>|
| Colorectal cancer operation<br>Patients previously submitted to right colectomy or rectosignoidectomy for cancer | Other: Interview, questionnaire, updated biochemical tests<br>* Patients will be interviewed and questioned about nutritional status, diet, drugs and diagnosis/clinical course of diabetes. Routine biochemical tests will be searched and if necessary updated.<br>|
| Bariatric patients<br>Morbidly obese participants who underwent antiobesity Roux-en-Y gastric bypass | Other: Interview, questionnaire, updated biochemical tests<br>* Patients will be interviewed and questioned about nutritional status, diet, drugs and diagnosis/clinical course of diabetes. Routine biochemical tests will be searched and if necessary updated.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fasting blood glucose | Glucose improvement or deterioration comparing preoperative versus late postoperative value. Classification according to the American Diabetes Association | 3-12 years change | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HbA1c | Same as fasting blood glucose (preoperative versus current change). Classification according to the American Diabetes Association. | 3-12 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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diabetes mellitus, prediabetes, fasting blood glucose, HbA1c, Roux en Y gastric bypass, Cancer gastrectomy, Cancer colorectal surgery