Surgery Or Lifestyle Intervention for Type 2 Diabetes (SOLID)

NCT ID: NCT01040468

Last Updated: 2016-08-19

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

Clinical Phase

PHASE3

Total Enrollment

7 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-09-30

Study Completion Date

2015-03-31

Brief Summary

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This research study will investigate the safety and effectiveness of weight loss surgery for overweight persons with type 2 diabetes. Eligible patients will undergo one of 2 types of weight loss surgery, Roux-en-Y gastric bypass, or laparoscopic adjustable gastric banding, or an intensive lifestyle modification. Participants will be closely followed for one year to compare the effects of these treatments on diabetes remission.

Detailed Description

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Conditions

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Type 2 Diabetes

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Roux-en-Y Gastric Bypass surgery

Surgical intervention for weight loss

Group Type ACTIVE_COMPARATOR

Roux-en-Y Gastric Bypass surgery

Intervention Type PROCEDURE

Surgical intervention for weight loss. This is a one-year study and participants will attend five study visits.

Laparoscopic Adjustable Gastric Banding surgery

Surgical intervention for weight loss

Group Type ACTIVE_COMPARATOR

Laparoscopic Adjustable Gastric Banding surgery

Intervention Type PROCEDURE

Surgical intervention for weight loss. This is a one-year study and participants will attend five study visits.

Intensive Lifestyle Modification

Lifestyle intervention for weight loss

Group Type ACTIVE_COMPARATOR

Intensive Lifestyle Modification

Intervention Type BEHAVIORAL

Intensive lifestyle modification program for weight loss. Participants randomized to this condition will receive an weekly individual treatment of 30 minutes for the first 6 months and every-other-week sessions from months 7 to 12. Treatment will be provided by a behavioral psychologist or registered dietitian following a structured curriculum used in our prior studies. During the first 4 months, participants will be prescribed a 1000-1200 kcal/d diet that provides four daily servings of meal replacement products (liquid shakes, cereals, meal bars, etc), combined with an evening dinner entree. Each serving of the meal replacement (HMR 170; Boston, MA) will provide 170 calories, with 16 g of protein, 22 g of carbohydrate, and 2 g of fat. Dinner entrees (containing at least 20 g of protein and approximately 220-260 kcal) will be consumed with a garden salad and a serving of fruit (and other vegetables allowed ad libitum throughout the day).

Interventions

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Roux-en-Y Gastric Bypass surgery

Surgical intervention for weight loss. This is a one-year study and participants will attend five study visits.

Intervention Type PROCEDURE

Laparoscopic Adjustable Gastric Banding surgery

Surgical intervention for weight loss. This is a one-year study and participants will attend five study visits.

Intervention Type PROCEDURE

Intensive Lifestyle Modification

Intensive lifestyle modification program for weight loss. Participants randomized to this condition will receive an weekly individual treatment of 30 minutes for the first 6 months and every-other-week sessions from months 7 to 12. Treatment will be provided by a behavioral psychologist or registered dietitian following a structured curriculum used in our prior studies. During the first 4 months, participants will be prescribed a 1000-1200 kcal/d diet that provides four daily servings of meal replacement products (liquid shakes, cereals, meal bars, etc), combined with an evening dinner entree. Each serving of the meal replacement (HMR 170; Boston, MA) will provide 170 calories, with 16 g of protein, 22 g of carbohydrate, and 2 g of fat. Dinner entrees (containing at least 20 g of protein and approximately 220-260 kcal) will be consumed with a garden salad and a serving of fruit (and other vegetables allowed ad libitum throughout the day).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Ages 18 to 65 years old.
* Diagnosis of type 2 diabetes.
* Individuals with a BMI of 30-40 kg/m2
* Approval for bariatric surgery (as confirmed by medical evaluation)
* Insurance coverage for bariatric surgery
* Willingness to change diet, physical activity and weight.
* Ability to communicate with the investigator and be legally competent, provide written informed consent.

Exclusion Criteria

* Diagnosis of type 1 diabetes, diagnosis of maturity-onset diabetes of the young (MODY), or latent autoimmune diabetes in adults (LADA) (all of which are associated with ß-cell destruction), daily insulin requirements \> 100 units, and poor preoperative glycemic control, as indicated by a HbA1c \> 6.5 - ≤ 8.5 or HbA1c \> 8.6 - \< 9.5 (individuals with this HbA1c value will require medical clearance and approval from the study physician).
* Children and adolescents are not eligible to participate in the study.
* Pregnant women (or those who intend to become pregnant during the study period) and women who are currently breastfeeding are not eligible to participate.
* Use of medications known to significantly increase body weight, such as chronic systemic steroids or certain psychiatric medications (e.g., lithium tricyclic antidepressants and anti-psychotic agents).
* Non-ambulatory individuals, defined as those who are unable to walk at least one city block without a cane or walker.
* Any major illnesses that the surgical team believes present too great a risk for surgery. These include severe cardiac and pulmonary diseases, as well as uncontrolled type 2 diabetes.
* Evidence of major depression or other psychiatric disorder (schizophrenia, bipolar disorder, major depression, bulimia nervosa, etc.) that is uncontrolled, poorly controlled, or, in the opinion of the Investigators, significantly interferes with daily living and functioning.
* Any current (past 12 months) substance abuse or dependence disorder.
* Participants with moderate anemia (Hgb \< 12 mg/dl for men and Hgb \< 11 mg/dl for women)
* Conditions that may falsely elevate or decrease HbA1c values, including hemolytic or iron-deficiency anemia, hemoglobinopathies, and uremia.
* Abnormal laboratory tests which are clinically significant per the investigator.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David B Sarwer, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Thomas A Wadden, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Noel Williams, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania Department of Surgery

Locations

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University of Pennsylvania Center for Weight and Eating Disorders

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

Related Links

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http://www.med.upenn.edu/weight/research.shtml

Center for Weight and Eating Disorders website

http://www.pennmedicine.org/bariatrics/

Bariatric Surgery Program at Penn website

Other Identifiers

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1RC1DK086132

Identifier Type: NIH

Identifier Source: secondary_id

View Link

809984

Identifier Type: -

Identifier Source: org_study_id

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