case_images: PMC11786166_01
case_images: Clinical course of the patient's body weight and HbA1c levels before and after his laparoscopic sleeve gastrectomy (LSG) and then after the revision surgery using Roux-en-Y gastric bypass (RYGB). The lower part shows glucose-lowering treatment medications. Changes in insulin secretion and insulin sensitivity parameters measured by oral glucose tolerance test (OGTT) after LSG and RYGB surgeries are shown in this figure. BW, body weight; DPP4i, dipeptidyl peptidase 4 inhibitor; Liraglutide, GLP-1 receptor agonist; LSG, laparoscopic sleeve gastrectomy; RYGB, Roux-en-Y gastric bypass.
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case_images: PMC11786166_01_JDI-16-343-g004.jpg
case_images: jdi14325-fig-0001
case_images: HbA1c levels (9.6%) during post-LSG (Figure 1). He frequently complained nausea and vomiting as symptoms of post-operative functional gastric angle stenosis and gastro-esophageal reflux after eating solid food. His BW fell further from 78.7 to 74 kg and his HbA1c improved to 7.3% with oral glucose-lowering drugs (Table 1, Figure 1).
case_images: A schematic illustration of the new RYGB surgery undergone in this patient.
case_images: JDI-16-343-g001.jpg
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case_images: Asian countries compared to Western countries, where the residual stomach is kept as a blind end in the conventional RYGB surgery (Figure 2). After the RYGB, the patient's nausea and vomiting upon food ingestion disappeared.
case_images: Plasma GLP-1, GIP, and glicentin levels during the 75-g oral glucose tolerance test (OGTT) 6-month after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) surgeries in a 65-year-old morbidly obese male patient with type 2 diabetes. Red solid line: glicentin (post-RYGB). Red dotted line: glicentin (post-LSG). Green solid line: GIP (post-RYGB). Green dotted line: GIP (post-LSG). Blue solid line: GLP-1 (post-RYGB). Blue dotted line: GLP-1 (post-LSG). These gut hormone levels were measured by using the following ELISA kits: GLP-1 (IBL), GIP (IBL), and glicentin (Mercodia).
case_images: JDI-16-343-g003.jpg
case_images: PMC11786166_01_JDI-16-343-g003.jpg
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case_images: Figure 3 depicts the secretory kinetics of GLP-1, GIP, and glicentin during 75 g OGTT.