Abstract
Oral glucose tolerance tests in gastrectomized subjects often reveal an oxyhperglycemia-type glucose tolerance curve. However, when diabetes mellitus is diagnosed according to the 1999 diagnostic criteria of the Japan Diabetes Society, the results often disagree with the diagnostic criteria. In the present study, such problems were reinvestigated using 75 g-OGTT and other parameters of glycemic control in 60 gastrectomized subjects selected from 2257 subjects examined during periodic medical check-ups. The mean plasma glucose levels at 0 minutes (FPG), 60 minutes (PG-1), and 120 minutes (PG-2) were 96.9mg/dl, 179.1mg/dl and 86.6mg/dl, respectively. According to the 1999 diagnostic criteria (JDS 1999), 6 subjects were classified as diabetics, 6 as borderline diabetics, and 47 as normal. The mean HbA1c level was 6.8%, which is higher than normal. Mean levels of fructosamine (FRA) and 1, 5-anhydro-D-glucitol (1, 5-AG) were 256μmol/l and 16.2μg/ml, respectively. Both of these values are within their normal ranges. In spite of the marked changes in plasma glucose levels (FPG, PG-1 and PG-2), the plasma glucose level was significantly correlated with the HbA1c, FRA, and 1, 5-AG levels. Before making a final diagnosis of diabetes mellitus, a thorough study of the patient's past history, especially when a gastrectomy has been undergone, together with a detailed analysis of laboratory data should be performed.
