Metabolomics of Roux-en-Y Gastric Bypass (RYGB) With Gastrostomy

NCT ID: NCT00887302

Last Updated: 2023-10-06

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

13 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-03-25

Study Completion Date

2012-10-12

Brief Summary

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This study is an investigation of the "metabolomics of RYGB with gastrostomy."

Detailed Description

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The rapid and durable remission of type II diabetes mellitis following the gastric bypass operation challenges the current concepts about the etiology of the disease. The surgery, which excludes food from the stomach, duodenum, and proximal jejunum, is quickly followed by a durable drop in glucose and insulin levels. As a result, 4 out of 5 diabetic, morbidly obese individuals who undergo the operation return to a long-term euglycemia with a prolongation of life and a reduction of health care costs.

The investigators at East Carolina University and those at Johnson and Johnson propose to further complete the profile of the upper gut by extending their observation to three additional human models. The investigators will study patients having the gastric band procedure, the gastric sleeve procedure, and those who have a gastric bypass but have a PEG tube inserted later.

Conditions

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Type II Diabetes Mellitus Obesity

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Restricted food intake without rerouting food flow cohort

Obese non-diabetic patients and diabetic patients undergoing gastric band surgery will be studied before they have surgery, 1 week after the band is adjusted to restrict food intake and again after they have lost the weight equal to that which gastric bypass patients loose 3 months after surgery (to match data we already have in the current study). All patients will be studied with an intravenous glucose tolerance test to measure insulin sensitivity and IV glucose-induced insulin secretion and a meal challenge to measure the secretion of metabolites and peptides.

Gastric Band

Intervention Type PROCEDURE

Places a band over the upper portion of the stomach.

Response to meal when a portion of the stomach is excluded from food flow cohort

Obese-diabetic patient undergoing gastric sleeve surgery will be studied before they have surgery, 1 week after surgery and again 3-6 months after surgery (to match data we already have in the current study). The patient will be studied with an intravenous glucose tolerance test to measure insulin sensitivity and insulin secretion and a meal challenge to measure the secretion of metabolites and peptides.

Gastric Sleeve

Intervention Type PROCEDURE

Stapling stomach vertically to reduce size of stomach and removal of larger curve portion of the stomach

Response to meal when a portion of the GI tract is excluded from food flow cohort

In approximately 6 patients/year our surgeons have to insert a gastrostomy tube into the bypassed stomach of gastric bypass patients. This provides a unique opportunity to see the changes in metabolites and peptides in blood in response to a meal delivered to the bypassed stomach, duodenum and proximal jejunum. Since we can not anticipate which patients will require this procedure, we cannot do tests before surgery, but we will do four tests post-operatively: (1) an IV glucose tolerance test, (2) an oral meal challenge (with Hi-cal), and (3) a meal challenge (identical to that given orally/Hi-Cal) delivered through the gastrostomy tube.

Gastrostomy subjects will also have a 4) test, a 75 gram dextrose meal challenge.

Gastrostomy Tube

Intervention Type PROCEDURE

Tube is inserted into the stomach that delivers nutrition directly into the stomach.

Interventions

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Gastric Band

Places a band over the upper portion of the stomach.

Intervention Type PROCEDURE

Gastric Sleeve

Stapling stomach vertically to reduce size of stomach and removal of larger curve portion of the stomach

Intervention Type PROCEDURE

Gastrostomy Tube

Tube is inserted into the stomach that delivers nutrition directly into the stomach.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Female
* 18-60 years of age
* BMI of 35-65
* Willing to comply with study requirements and long term follow-up
* Capable of understanding the requirements and consequences of surgery and the study
* Is scheduled to have bariatric surgery performed
* Has a negative pregnancy test

Exclusion Criteria

* Repeat gastric bypass procedure
* Patients who are unable to hold their insulin coverage for 48 hours prior to research visits
* Patients taking TZDs
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Johnson & Johnson

INDUSTRY

Sponsor Role collaborator

East Carolina University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Walter Pories, MD

Role: PRINCIPAL_INVESTIGATOR

East Carolina University

Locations

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East Carolina University Brody School of Medicine

Greenville, North Carolina, United States

Site Status

Countries

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United States

Other Identifiers

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J&J Ethicon

Identifier Type: -

Identifier Source: org_study_id

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