Multicentric Prospective Randomized Trial on Surgery Versus Standard Medical Care in Type 2 Diabetic Patients BMI 30-35

NCT ID: NCT01041768

Last Updated: 2010-03-30

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-03-31

Study Completion Date

2015-12-31

Brief Summary

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200 type 2 diabetic patients -BMI between 30-35- will be submitted to bariatric surgery (biliopancreatic diversion BPD or gastric bypass GBP ) and 100 will receive standard medical treatment.

Subjects will be monitored during a 5 year period to assess the effects of the surgical procedures on diabetes resolution and control at 1, 3 and 5 years.

Detailed Description

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The study is a multicentric prospective 2-arm randomized controlled trial. Only Centers with at least 50 bariatric surgeries performed during the time window January 2007 and September 2008 will be allowed to participate in the study.

Each Collaborating Center participating in the study will perform only one type of surgical procedure (GBP or BPD), depending on which one it is more familiar with.

Patients will be randomly assigned with a 2 to 1 ratio to receive either bariatric surgery (BS) (either GBP or BPD) or standard antidiabetic care (AC). The randomization will be centralized in the Coordinating Center. Patients assigned to BS will undergo GBP or BPD, depending on each Collaborating Center. Recruitment will continue, independently of the number of recruited patients per center, until the target of 200 GBP+BPD patients, and 100 AC patients will be attained.

After one year since enrollment, patients in AC group will be offered the choice to undergo one of the two surgical procedures, and then will follow the same protocol study as the other surgical patients. In addition, each Collaborating Center will be responsible for selecting one diabetic subject for each operated patient, matched as closely as possible with the patients assigned to surgical therapy, from the local population in medical treatment. These patients will serve as controls for long term mortality and morbidity.

Conditions

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Diabetes Mellitus

Keywords

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Type 2 Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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antidiabetic medical therapy

Group Type ACTIVE_COMPARATOR

Bariatric surgery

Intervention Type PROCEDURE

Biliopancreatic diversion consists of a distal gastrectomy with a long Roux-en-Y reconstruction, where the enteroenterostomy is placed 50 cm proximal to the ileocecal valve; Gastric bypass consists of creating a small proximal gastric pouch by division of the upper stomach, with reconstruction of the GI continuity by means of a Roux-en-Y loop

Bariatric Surgery

Group Type EXPERIMENTAL

Bariatric surgery

Intervention Type PROCEDURE

Biliopancreatic diversion consists of a distal gastrectomy with a long Roux-en-Y reconstruction, where the enteroenterostomy is placed 50 cm proximal to the ileocecal valve; Gastric bypass consists of creating a small proximal gastric pouch by division of the upper stomach, with reconstruction of the GI continuity by means of a Roux-en-Y loop

Interventions

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Bariatric surgery

Biliopancreatic diversion consists of a distal gastrectomy with a long Roux-en-Y reconstruction, where the enteroenterostomy is placed 50 cm proximal to the ileocecal valve; Gastric bypass consists of creating a small proximal gastric pouch by division of the upper stomach, with reconstruction of the GI continuity by means of a Roux-en-Y loop

Intervention Type PROCEDURE

Other Intervention Names

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biliopancreatic diversion gastric bypass

Eligibility Criteria

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Inclusion Criteria

* BMI ≥30 and ≤34.9 kg/m2
* age between 35 and 70 years
* duration of diabetes ≥ 5 years
* poor glycemic control (i.e., HbA1c ≥ 8%) in spite a medical antidiabetic therapy in accordance with good clinical practice (GCP)
* presence of significant co-morbidities or complications (such as dyslipidemia, arterial hypertension, impaired renal function, neuropathy, retinopathy, CVD)

Exclusion Criteria

* specific contraindication to obesity surgery or GBP or BPD, including any gastric alteration specifically contraindicating GBP
* HbA1c \< 8%
* positive autoantibodies anti-pancreas islet
* serum C-peptide \< 0.5 ng/ml
* pregnancy
* medical conditions requiring acute hospitalisation
* severe diabetes complications or associated medical conditions (such as blindness, end-stage renal failure, liver cirrhosis, malignancy, chronic congestive heart failure
* recent (within preceding 12 months) myocardial infarction, stroke or TIA
* unstable angina pectoris
* psychological conditions which may hamper patient's cooperation
* geographic inaccessibility
* any condition which, in the judgement of the Investigator, may make risky the participation in the study or bias the results
Minimum Eligible Age

35 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ospedale di Desenzano del Garda

UNKNOWN

Sponsor Role collaborator

Azienda Ospedaliero, Universitaria Pisana

OTHER

Sponsor Role collaborator

Azienda Ospedaliera Santa Maria Degli Angeli

OTHER

Sponsor Role collaborator

IRCCS Multimedica

OTHER

Sponsor Role collaborator

Istituto Clinico Humanitas

OTHER

Sponsor Role collaborator

Humanitas Gavazzeni di Bergamo

UNKNOWN

Sponsor Role collaborator

Azienda Sanitaria Locale n. 2 - Lanciano Vasto Chieti

OTHER

Sponsor Role collaborator

Ente Ospedaliero Ospedali Galliera

OTHER

Sponsor Role collaborator

Ospedale S. Giovanni Bosco

OTHER

Sponsor Role collaborator

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

OTHER

Sponsor Role collaborator

University of Rome Tor Vergata

OTHER

Sponsor Role collaborator

Azienda Ospedaliera San Giovanni Battista

OTHER

Sponsor Role collaborator

Ospedale S. Timoteo, Termoli

UNKNOWN

Sponsor Role collaborator

Ospedale Marino, Cagliari

UNKNOWN

Sponsor Role collaborator

Hospital San Pietro Fatebenefratelli

OTHER

Sponsor Role collaborator

Azienda Ospedaliera Universitaria Policlinico

OTHER

Sponsor Role collaborator

Azienda ospedaliera Garibaldi Catania

UNKNOWN

Sponsor Role collaborator

IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

OTHER

Sponsor Role lead

Responsible Party

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Azienda Ospedaliera Universitaria "San Martino"

Principal Investigators

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Nicola Scopinaro, MD

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliera Universitaria "San Martino", Genova, Italy

Locations

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Azienda Ospedaliera Universitaria "San Martino"

Genova, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Nicola Scopinaro, MD

Role: CONTACT

Phone: +39 010 3537301

Email: [email protected]

Facility Contacts

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Nicola Scopinaro, MD

Role: primary

Other Identifiers

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DIA-CHIR-MULT-BMI 30-35

Identifier Type: -

Identifier Source: org_study_id