Metabolic improvement effects of jejunoileal side-to-side anastomosis in patients with type 2 diabetes and the glucagon-like peptide-1 mechanism

Abstract

Wang et al explored the metabolic improvement effects of jejunoileal side-to-side anastomosis in patients with type 2 diabetes mellitus (T2DM), focusing on its multitarget metabolic regulatory potential through enhanced secretion of glucagon-like peptide-1. This surgical procedure alters the direction of nutrient flow, activates distal ileal L cells, and increases endogenous glucagon-like peptide-1 levels, supporting glucose homeostasis, enhancing insulin sensitivity, regulating body weight, and improving cardiovascular health. This structural adjustment transforms the gastrointestinal tract into an active endocrine regulatory organ, providing a pathway for metabolic improvement in patients with T2DM and other complex metabolic disorders. Although this procedure demonstrates significant metabolic improvements within 3-6 months after surgery, integrating hormone level measurements, metabolic marker analysis, and long-term follow-up has become crucial for exploring the complex mechanisms of T2DM in the field of metabolic surgery and T2DM management. Multidisciplinary collaboration involving support from endocrinology, nutrition, and rehabilitation teams before and after surgery is becoming increasingly vital in the long-term management of patients with T2DM. This collaboration optimizes surgical outcomes and enhances metabolic management. Side-to-side anastomosis shows potential in the multitarget metabolic management of T2DM, providing an additional intervention option for patients with T2DM and metabolic disorders.

Keywords: Type 2 diabetes mellitus; Jejunoileal side-to-side anastomosis; Roux-en-Y gastric bypass; Glucagon-like peptide-1; Bariatric surgery; Multidisciplinary care

Core Tip: Type 2 diabetes mellitus (T2DM) remains a global health challenge with rising prevalence and complications. Metabolic surgery, particularly jejunoileal side-to-side anastomosis, offers promising outcomes by enhancing glucagon-like peptide-1 secretion and improving glucose homeostasis and weight management. This innovative procedure transforms the gastrointestinal tract into an active metabolic regulator, thus addressing the multifaceted nature of T2DM. Multidisciplinary collaboration involving endocrinologists, nutritionists, and rehabilitation specialists optimizes outcomes and long-term management. Although metabolic surgery shows significant short-term benefits, further high-quality studies are required to assess its long-term efficacy. Personalized approaches that incorporate patient preferences and comprehensive follow-up are essential for optimal T2DM care.