Postoperative remission of diabetes mellitus after gastrectomy in patients with diabetes mellitus and gastric cancer

Background/aim: We investigated the postoperative treatment status for diabetes mellitus and perioperative HbA1c levels in patients with diabetes mellitus and examined the effects of clinical factors on the remission of diabetes mellitus. Patients and methods: In this study, 126 patients with gastric cancer were considered to have diabetes mellitus preoperatively, of whom 79 were treated with oral antidiabetic drugs and/or insulin treatment. We compared diabetic treatment status and HbA1c values between the preoperative and postoperative periods in patients who underwent gastrectomy and examined the effects of clinical factors on improving diabetes mellitus. Results: Of the 79 patients treated preoperatively for diabetes mellitus, 34(43%) discontinued all medications for diabetes mellitus and 37 (47%) reduced the therapeutic dose or switched from insulin to oral antidiabetic drugs. Total gastrectomy was an independent factor for the remission of antidiabetic treatments after gastrectomy. Concerning the HbA1c level, only the absence of preoperative insulin use was an independent factor for the improvement. However, reconstruction was not a significant correlated factor for the improvement of postoperative HbA1c levels and the remission of antidiabetic medications after distal gastrectomy. Conclusions: Almost all patients discontinued or reduced the dose of antidiabetic medications after gastrectomy in clinical practice, and special attention should be paid in the management methods for diabetes mellitus in patients who underwent total gastrectomy for gastric cancer.