Longitudinal Cohort Study Comparing 2 Surgical Techniques in Patients With Class 3 Obesity and Type 2 Diabetes

NCT ID: NCT00688974

Last Updated: 2016-08-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

56 participants

Study Classification

OBSERVATIONAL

Study Start Date

2004-05-31

Study Completion Date

2012-09-30

Brief Summary

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Wight loss surgery provides good glycemic control in type 2 diabetes. The technique of "Roux-en-Y gastric bypass" is more effective than the "Adjustable Gastric Band" on weight loss.

This longitudinal cohort study will compare the effectiveness of the Roux-en-Y gastric bypass and Adjustable Gastric Banding on glycemic control in type 2 diabetes and explore the responsible mechanisms.

The evaluation will be made preoperatively and 1 year later as assessed by the decline in HbA1c. An evaluation will also be carried out after a weight loss of 10% to indicate whether the observed difference is independent of weight loss.

Detailed Description

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Type 2 diabetes is a condition often associated with obesity and often difficult to control. In patients with severe obesity, surgical treatment allows a sustainable weight loss and higher than that obtained with other treatments available. In most cases, surgery also reduces significantly the comorbidities of obesity and diabetes in particular. Among the various technical options, adjustable gastric band (AGB) is the simplest and by far the most used in France.

Roux-en-Y gastric bypass (RYGB) is a more complicated intervention combining gastrointestinal malabsorption- duodeno-jejunal and gastric reduction and allows a higher weight loss. Several studies also suggest that the technique has a remarkable efficiency on glycemic control, justifying the extension of its readings/indications. No study controlled, however, has compared these two techniques.

The objective of this study is to compare the efficiency of RYGB vs AGB on glycemic control in type 2 diabetes. Although some studies have compared AGB and RYGB, none have compared their effectiveness on post prandial glucose control in patients with diabetes. It is generally recognized that the effectiveness of RYGB on diabetes is independent of the weight loss, but this has never been demonstrated.

By demonstrating the superiority of RYGB vs AGB, and identifying the responsible mechanisms, the study will expand the indications of RYGB in the treatment of type 2 diabetes. Weight loss surgery offers a unique model for the clinical study of the pathophysiology of type 2 diabetes.

Main objective:

* To compare the effectiveness of RYGB vs AGB on glucose control in obese patients with type 2 diabetes.

Secondary Objectives:

* demonstrate that the better outcome achieved with RYGB is independent of weight loss.
* Identify the mechanisms underlying the better outcome of RYGB

Conditions

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Obesity Type 2 Diabetes

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Roux-en-Y gastric bypass

Patients with class 3 obesity and type 2 diabetes submitted to Roux-en-Y gastric bypass

Roux-en-Y gastric bypass

Intervention Type PROCEDURE

Laparoscopic Roux-en-Y gastric bypass

Adjustable gastric banding

Patients with class 3 obesity and type 2 diabetes submitted to adjustable gastric banding

Adjustable gastric band

Intervention Type PROCEDURE

Laparoscopic adjustable gastric band

Healthy controls

Non-obese, non-diabetic adults

No interventions assigned to this group

Interventions

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Roux-en-Y gastric bypass

Laparoscopic Roux-en-Y gastric bypass

Intervention Type PROCEDURE

Adjustable gastric band

Laparoscopic adjustable gastric band

Intervention Type PROCEDURE

Other Intervention Names

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Gastric bypass Gastric Banding

Eligibility Criteria

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Inclusion Criteria

* Age between 18 and 70 years AND
* BMI \> 35
* Type 2 diabetes
* Obesity for more than 5 years OR
* normoglycemia
* BMI\< 30

Exclusion Criteria

* Secondary obesity due to an endocrinopathy
* Chronic pathology (neoplasia, cirrhosis, disease of system)
* Psychosis, alcoholic addiction or narcotics.
* Contre-indications to the anaesthesia
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital, Lille

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Francois PATTOU

Role: PRINCIPAL_INVESTIGATOR

Lille University Hospital

Locations

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Lille University Hospital

Lille, Nord, France

Site Status

Countries

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France

Other Identifiers

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2004/0412

Identifier Type: OTHER

Identifier Source: secondary_id

DGS 2004/0123

Identifier Type: -

Identifier Source: org_study_id

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