The Effects of Glycemic Optimization Before Gastric Bypass Surgery

NCT ID: NCT01353118

Last Updated: 2022-03-14

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-05-31

Study Completion Date

2016-12-31

Brief Summary

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Metabolic surgery such as gastric bypass, gastric banding or sleeve gastrectomy operations can cause rapid and uncontrolled reductions in blood glucose. There is limited information on whether:

* metabolic surgery is superior to modern medical care for glycaemic control and type 2 diabetes remission.
* metabolic surgery is safe for microvascular complications of Type 2 diabetes
* good glycaemic control pre surgery has any effects on the long term glycaemia and complications of type 2 diabetes.

This study aims to assess:

1. whether metabolic surgery is better for diabetes control compared to medical treatment.
2. whether metabolic surgery is safe for eye, nerve and kidney complications.
3. whether good sugar control before metabolic surgery improves the long term effects of sugar control and microvascular complications.

Detailed Description

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This is a prospective study involving 150 patients with type 2 diabetes mellitus (T2DM) and obesity. One hundred patients will undergo gastric bypass surgery whilst 50 will be treated with best medical care. The surgical patient group will be randomised to either immediate surgery or 3 months of medical glycaemic optimisation followed by surgery (n=50 group).

Intervention Group A: Patients will undergo gastric bypass surgery within 3 months after randomisation without any pre operative optimisation of glycaemic control.

Group B: Patients will undergo gastric bypass 3-6 months after randomisation. During this period the group will receive modern best medical care based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) guidelines. Glycaemic optimisation will be achieved with particular attention to the avoidance of hypoglycaemia.

Group C: Obese patients with T2DM (who choose not to have surgery) will be treated with best medical care based on the ADA/EASD guidelines including anti-diabetes/obesity pharmacotherapy, access to a trained dietician and exercise programme.

Conditions

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Type 2 Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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gastric bypass

Group A: Patients will undergo gastric bypass surgery within 3 months after randomisation without any pre operative optimisation of glycaemic control.

Group Type NO_INTERVENTION

No interventions assigned to this group

Gastric bypass 2

Gastric bypass 2 (Group B):Patients will undergo gastric bypass 3-6 months after randomisation. During this period the group will receive modern best medical care based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) guidelines. Glycaemic optimisation will be achieved in a gradual manner with particular attention to the avoidance of hypoglycaemia

Group Type ACTIVE_COMPARATOR

gastric bypass

Intervention Type BIOLOGICAL

Optimise glucose control within 3 months before operation

Interventions

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gastric bypass

Optimise glucose control within 3 months before operation

Intervention Type BIOLOGICAL

Other Intervention Names

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Type 2 diabetes glucose optimisation microvascular complications retinopathy neuropathy nephropathy Gastric bypass with

Eligibility Criteria

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Inclusion Criteria

1. Adult patients with T2DM and BMI above 35kg/m2
2. HbA1c ≥ 8.5% and/or the presence of at least one microvascular complication.

Exclusion Criteria

* End stage retinopathy, nephropathy or neuropathy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Carel Le Roux

Consultant metabolic medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Carel Le Roux, MBChB, PhD

Role: PRINCIPAL_INVESTIGATOR

Imperial College London

Locations

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Imperial Weight Centre, Charing Cross Hospital,

London, , United Kingdom

Site Status

Charing Cross Hospital

London, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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GLUCOSURG 2

Identifier Type: -

Identifier Source: org_study_id

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