Increased jejunal glucose uptake by 18F-FDG PET/CT with remission of type 2 diabetes after bariatric surgery

초록

Background and Aims: Bariatric surgery is considered as an effective method to improve remission of type 2 diabetes (T2DM). Although the detailed underlying mechanism is unclear, the reprogramming of intestinal glucose metabolism is regarded as the most probably the key factor underlying the remission of T2DM after bariatric surgery. We aimed to investigate the change of intestinal glucose metabolism using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the patient with remission of T2DM after bariatric surgery. Methods: The patient who had been diagnosed with T2DM 15 years ago and had been taking insulin for 6 years underwent subtotal gastrectomy using Billroth II resection. 18F-FDG PET/CT was taken before (baseline) and after (1-year follow-up) the surgery Results: Pre-operative baseline 18F-FDG PET/CT exhibited no significant increase tracer uptake in intestines. At the 1-year follow-up after surgery, the patients’ T2DM seemed to be completely cured and 18F-FDG PET/CT showed increased tracer uptake in jejunum. Conclusions: We found increased jejunal glucose uptake by 18F-FDG PET/CT with remission of T2DM after bariatric surgery. This finding supports the hypothesis that the reprogramming of intestinal glucose metabolism is the key factor underlying the remission of T2DM.