Yang J, Zhang CZ, Wang JJ, Zhang J. Metabolic improvement effects of jejunoileal side-to-side anastomosis in patients with type 2 diabetes and the glucagon-like peptide-1 mechanism. World J Diabetes 2025; 16(4): 103567 [DOI: 10.4239/wjd.v16.i4.103567]
Corresponding Author of This Article
Jing Zhang, MD, Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People’s Hospital, No. 183 Yiling Avenue, Yichang 443000, Hubei Province, China. zhangjing@ctgu.edu.cn
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jian Yang, Cheng-Zhi Zhang, Jiao-Jiao Wang, Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People’s Hospital, Yichang 443000, Hubei Province, China
Jian Yang, Cheng-Zhi Zhang, Jiao-Jiao Wang, Jing Zhang, Hubei Key Laboratory of Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
Jian Yang, Cheng-Zhi Zhang, Jiao-Jiao Wang, Jing Zhang, Hubei Provincial Clinical Research Center for Ischemic Cardiovascular Disease, Yichang 443000, Hubei Province, China
Cheng-Zhi Zhang, Jiao-Jiao Wang, Jing Zhang, Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People’s Hospital, Yichang 443000, Hubei Province, China
Co-first authors: Jian Yang and Cheng-Zhi Zhang.
Author contributions: Yang J, Zhang J, and Zhang CZ wrote the original draft and contributed to conceptualization, reviewing, and editing; Zhang CZ and Yang J made equal and significant intellectual contributions to this work; Wang JJ was responsible for creating the illustrations and tables; All authors read and approved the final version of the manuscript.
Supported by the National Natural Science Foundation of China, No. 82471616, No. 82170418 and No. 82271618; Natural Science Foundation of Hubei Province, No. 2022CFA015; Central Guiding Local Science and Technology Development Project, No. 2022BGE237; Key Research and Development Program of Hubei Province, No. 2022BCE001 and No. 2023BCB139; and Hubei Provincial Health Commission Project, No. WJ2023M151.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Zhang, MD, Central Laboratory, The First College of Clinical Medical Science, China Three Gorges University and Yichang Central People’s Hospital, No. 183 Yiling Avenue, Yichang 443000, Hubei Province, China. zhangjing@ctgu.edu.cn
Received: November 28, 2024 Revised: January 6, 2025 Accepted: January 14, 2025 Published online: April 15, 2025 Processing time: 97 Days and 13.6 Hours
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.
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.
