Trial Outcomes & Findings for Treatment of Diabetes After Gastric Bypass With Sitagliptin (NCT NCT01512797)

NCT ID: NCT01512797

Last Updated: 2019-01-22

Results Overview

Glucose levels were measured in study participants while fasting and periodically over 3 hours after drinking a 200 kcal mixed meal test, before and after intervention (Sitagliptin or Placebo).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

37 participants

Primary outcome timeframe

Baseline and ~4 weeks

Results posted on

2019-01-22

Participant Flow

Recruitment for this study took place from July 2012-July 2016. Recruitment and data collection for this study was started at St. Luke's Hospital in New York, NY and later moved to Columbia University Medical Center in New York, NY.

37 participants were enrolled, however only 32 participated in study procedures and demographic information collection.

Participant milestones

Participant milestones
Measure
Sitagliptin Phosphate
100 mg/day sitagliptin phosphate (Januvia) PO once a day for 4-5 weeks Sitagliptin phosphate: 100 mg/day orally
Placebo
1 Placebo pill / day PO once a day for 4-5 weeks Placebo: 1 Placebo Pill per day
Overall Study
STARTED
16
16
Overall Study
COMPLETED
16
16
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Treatment of Diabetes After Gastric Bypass With Sitagliptin

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Sitagliptin Phosphate
n=16 Participants
100 mg/day sitagliptin phosphate (Januvia) PO once a day for 4-5 weeks Sitagliptin phosphate: 100 mg/day orally
Placebo
n=16 Participants
1 Placebo pill / day PO once a day for 4-5 weeks Placebo: 1 Placebo Pill per day
Total
n=32 Participants
Total of all reporting groups
Age, Continuous
54.2 years
STANDARD_DEVIATION 9.0 • n=5 Participants
58.4 years
STANDARD_DEVIATION 7.0 • n=7 Participants
56.3 years
STANDARD_DEVIATION 8.2 • n=5 Participants
Sex: Female, Male
Female
15 Participants
n=5 Participants
14 Participants
n=7 Participants
29 Participants
n=5 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic White
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic Black
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Race/Ethnicity, Customized
African-American
5 Participants
n=5 Participants
4 Participants
n=7 Participants
9 Participants
n=5 Participants
BMI
32.70 kg/m2
STANDARD_DEVIATION 5.22 • n=5 Participants
36.12 kg/m2
STANDARD_DEVIATION 7.69 • n=7 Participants
34.41 kg/m2
STANDARD_DEVIATION 6.69 • n=5 Participants
HbA1c
7.46 %
STANDARD_DEVIATION 0.78 • n=5 Participants
6.96 %
STANDARD_DEVIATION 0.70 • n=7 Participants
7.21 %
STANDARD_DEVIATION 0.77 • n=5 Participants
Time since Roux-en-Y gastric bypass surgery
5.56 years
STANDARD_DEVIATION 3.77 • n=5 Participants
5.57 years
STANDARD_DEVIATION 2.80 • n=7 Participants
5.56 years
STANDARD_DEVIATION 3.27 • n=5 Participants
Type 2 Diabetes Mellitus duration prior to Roux-en-Y gastric bypass surgery
12.9 years
STANDARD_DEVIATION 11.0 • n=5 Participants
12.9 years
STANDARD_DEVIATION 9.3 • n=7 Participants
12.9 years
STANDARD_DEVIATION 10.0 • n=5 Participants
Type 2 Diabetes Mellitus remission duration prior to study
2.72 years
STANDARD_DEVIATION 3.10 • n=5 Participants
2.16 years
STANDARD_DEVIATION 2.74 • n=7 Participants
2.44 years
STANDARD_DEVIATION 2.89 • n=5 Participants
Maximum Weight before Roux-en-Y gastric bypass surgery
122.45 kg
STANDARD_DEVIATION 19.0 • n=5 Participants
132.89 kg
STANDARD_DEVIATION 24.23 • n=7 Participants
127.7 kg
STANDARD_DEVIATION 22.1 • n=5 Participants
Weight at Roux-en-Y gastric bypass
117.5 kg
STANDARD_DEVIATION 20.4 • n=5 Participants
130.23 kg
STANDARD_DEVIATION 24.6 • n=7 Participants
123.9 kg
STANDARD_DEVIATION 23.1 • n=5 Participants
Nadir weight after Roux-en-Y gastric bypass
73.51 kg
STANDARD_DEVIATION 17.52 • n=5 Participants
82.93 kg
STANDARD_DEVIATION 13.38 • n=7 Participants
78.22 kg
STANDARD_DEVIATION 16.06 • n=5 Participants
Current Weight
85.98 kg
STANDARD_DEVIATION 15.21 • n=5 Participants
95.82 kg
STANDARD_DEVIATION 19.71 • n=7 Participants
90.90 kg
STANDARD_DEVIATION 18.02 • n=5 Participants
Current weight loss since Roux-en-Y gastric bypass
31.53 kg
STANDARD_DEVIATION 11.90 • n=5 Participants
34.47 kg
STANDARD_DEVIATION 13.91 • n=7 Participants
33.00 kg
STANDARD_DEVIATION 12.82 • n=5 Participants
Weight regain from nadir weight
12.73 kg
STANDARD_DEVIATION 10.70 • n=5 Participants
12.96 kg
STANDARD_DEVIATION 10.94 • n=7 Participants
12.84 kg
STANDARD_DEVIATION 10.64 • n=5 Participants
Number of oral type 2 diabetes mellitus medications prior to Roux-en-Y gastric bypass
1.88 number of medications
STANDARD_DEVIATION 0.89 • n=5 Participants
1.75 number of medications
STANDARD_DEVIATION 0.93 • n=7 Participants
1.81 number of medications
STANDARD_DEVIATION 0.90 • n=5 Participants
Participants on insulin prior to RYGB
10 Participants
n=5 Participants
10 Participants
n=7 Participants
20 Participants
n=5 Participants
Participants on insulin at time of study
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Total Cholesterol
172.0 mg/dL
STANDARD_DEVIATION 41.5 • n=5 Participants
151.78 mg/dL
STANDARD_DEVIATION 32.67 • n=7 Participants
161.1 mg/dL
STANDARD_DEVIATION 37.67 • n=5 Participants
Triglycerides
147.3 mg/dL
STANDARD_DEVIATION 123.9 • n=5 Participants
124.7 mg/dL
STANDARD_DEVIATION 50.2 • n=7 Participants
135.1 mg/dL
STANDARD_DEVIATION 90.6 • n=5 Participants
High-density lipoprotein
54.83 mg/dL
STANDARD_DEVIATION 15.21 • n=5 Participants
59.21 mg/dL
STANDARD_DEVIATION 29.39 • n=7 Participants
57.19 mg/dL
STANDARD_DEVIATION 23.58 • n=5 Participants
Low-density lipoprotein
89.18 mg/dL
STANDARD_DEVIATION 39.92 • n=5 Participants
76.79 mg/dL
STANDARD_DEVIATION 28.24 • n=7 Participants
82.24 mg/dL
STANDARD_DEVIATION 33.70 • n=5 Participants
Systolic blood pressure
124.8 mm Hg
STANDARD_DEVIATION 21.23 • n=5 Participants
119.1 mm Hg
STANDARD_DEVIATION 14.4 • n=7 Participants
122.23 mm Hg
STANDARD_DEVIATION 18.4 • n=5 Participants
Diastolic blood pressure
74.69 mm Hg
STANDARD_DEVIATION 12.26 • n=5 Participants
69.77 mm Hg
STANDARD_DEVIATION 11.05 • n=7 Participants
72.48 mm Hg
STANDARD_DEVIATION 11.79 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline and ~4 weeks

Population: All patients completed study in both arms.

Glucose levels were measured in study participants while fasting and periodically over 3 hours after drinking a 200 kcal mixed meal test, before and after intervention (Sitagliptin or Placebo).

Outcome measures

Outcome measures
Measure
Sitagliptin Phosphate
n=16 Participants
100 mg/day sitagliptin phosphate (Januvia) PO once a day for 4-5 weeks Sitagliptin phosphate: 100 mg/day orally
Placebo
n=16 Participants
1 Placebo pill / day PO once a day for 4-5 weeks Placebo: 1 Placebo Pill per day
Change in Postprandial Glucose Levels After Mixed Meal Test
Pre-Intervention Fasting Glucose
7.10 mmol/L
Standard Deviation 1.74
6.52 mmol/L
Standard Deviation 1.21
Change in Postprandial Glucose Levels After Mixed Meal Test
Post-Intervention Fasting Glucose
6.44 mmol/L
Standard Deviation 1.25
6.39 mmol/L
Standard Deviation 1.23
Change in Postprandial Glucose Levels After Mixed Meal Test
Pre-Intervention 120 minute glucose
7.51 mmol/L
Standard Deviation 1.91
7.01 mmol/L
Standard Deviation 1.38
Change in Postprandial Glucose Levels After Mixed Meal Test
Post-Intervention 120 minute glucose
6.79 mmol/L
Standard Deviation 1.65
6.97 mmol/L
Standard Deviation 1.47
Change in Postprandial Glucose Levels After Mixed Meal Test
Pre-Intervention Average Glucose during MMT
8.55 mmol/L
Standard Deviation 1.95
8.12 mmol/L
Standard Deviation 1.14
Change in Postprandial Glucose Levels After Mixed Meal Test
Post-Intervention Average Glucose during MMT
7.84 mmol/L
Standard Deviation 1.47
7.86 mmol/L
Standard Deviation 1.04

PRIMARY outcome

Timeframe: Baseline and ~4 weeks

Glucose levels were measured in study participants while fasting and periodically over 3 hours after drinking a 200 kcal mixed meal test, before and after intervention (Sitagliptin or Placebo). AUC was measured by trapezoidal method.

Outcome measures

Outcome measures
Measure
Sitagliptin Phosphate
n=16 Participants
100 mg/day sitagliptin phosphate (Januvia) PO once a day for 4-5 weeks Sitagliptin phosphate: 100 mg/day orally
Placebo
n=16 Participants
1 Placebo pill / day PO once a day for 4-5 weeks Placebo: 1 Placebo Pill per day
Change in Area Under the Curve (AUC) Glucose Levels After Mixed Meal Test
Pre-Intervention Glucose AUC
8.31 mmol/L/min
Standard Deviation 1.92
7.96 mmol/L/min
Standard Deviation 1.20
Change in Area Under the Curve (AUC) Glucose Levels After Mixed Meal Test
Post-Intervention Glucose AUC
7.67 mmol/L/min
Standard Deviation 1.59
7.75 mmol/L/min
Standard Deviation 1.16

SECONDARY outcome

Timeframe: Baseline and ~4 weeks

Satiety levels were measured in study participants while they were fasting and periodically over a three hour period after drinking a 200 kcal meal drink, before and after intervention via a Visual Analog Scale. Participants were asked to mark on a 0 to 150 millimeter scale their response to the following question: "How full do you feel right now?" with lower scores indicating "not full at all" and higher scores indicating "extremely full."

Outcome measures

Outcome measures
Measure
Sitagliptin Phosphate
n=16 Participants
100 mg/day sitagliptin phosphate (Januvia) PO once a day for 4-5 weeks Sitagliptin phosphate: 100 mg/day orally
Placebo
n=16 Participants
1 Placebo pill / day PO once a day for 4-5 weeks Placebo: 1 Placebo Pill per day
Effect of Sitagliptin vs Placebo on Satiety in Patients With Type 2 Diabetes After Gastric Bypass Surgery
Pre-Intervention fasting satiety level
51.94 mm
Standard Deviation 87.40
49.06 mm
Standard Deviation 39.36
Effect of Sitagliptin vs Placebo on Satiety in Patients With Type 2 Diabetes After Gastric Bypass Surgery
Post-Intervention fasting satiety level
22.38 mm
Standard Deviation 22.03
58.50 mm
Standard Deviation 113.23
Effect of Sitagliptin vs Placebo on Satiety in Patients With Type 2 Diabetes After Gastric Bypass Surgery
Pre-Intervention 180 minute glucose
37.81 mm
Standard Deviation 40.95
50.50 mm
Standard Deviation 59.37
Effect of Sitagliptin vs Placebo on Satiety in Patients With Type 2 Diabetes After Gastric Bypass Surgery
Post-Intervention 180 minute glucose
43.69 mm
Standard Deviation 43.85
103.75 mm
Standard Deviation 198.35

SECONDARY outcome

Timeframe: 6 weeks

Side effects to Sitagliptin or Placebo were measured in study participants via Sigstad score questionnaire, while fasting and periodically during a 3 hour period after drinking a 200 kcal meal drink, before and after intervention. The Sigstad scoring system is based on the participants report of the occurrence of 16 symptoms suggestive of the dumping syndrome. Each symptom is given a different score. For example, desire to sit down (+4), breathlessness (+3), dizziness (+2), nausea (+1), vomiting (-4) etc.The scale can range from -5 to 34. Scores greater than or equal to 7, after glucose intake, are considered diagnostic of dumping syndrome.

Outcome measures

Outcome measures
Measure
Sitagliptin Phosphate
n=16 Participants
100 mg/day sitagliptin phosphate (Januvia) PO once a day for 4-5 weeks Sitagliptin phosphate: 100 mg/day orally
Placebo
n=16 Participants
1 Placebo pill / day PO once a day for 4-5 weeks Placebo: 1 Placebo Pill per day
Occurrence of Side Effects In Relation to Sitagliptin
Pre-Intervention Average Sigstad Score
2.15 units on Sigstad scale
Standard Deviation 1.97
5.58 units on Sigstad scale
Standard Deviation 3.41
Occurrence of Side Effects In Relation to Sitagliptin
Post-Intervention Average Sigstad Score
2.24 units on Sigstad scale
Standard Deviation 2.34
4.40 units on Sigstad scale
Standard Deviation 3.10

SECONDARY outcome

Timeframe: Pre-Intervention and Post-Intervention

Active GLP-1 (Fasting and during a Mixed Meal Test). The Change in Fasting Active GLP-1 refers to the change in fasting active GLP-1 from pre-intervention time point to post-intervention time point. The Change in Peak Active GLP-1 refers to the change in the peak active GLP-1 level from the pre-intervention time point to post-intervention time point.

Outcome measures

Outcome measures
Measure
Sitagliptin Phosphate
n=16 Participants
100 mg/day sitagliptin phosphate (Januvia) PO once a day for 4-5 weeks Sitagliptin phosphate: 100 mg/day orally
Placebo
n=16 Participants
1 Placebo pill / day PO once a day for 4-5 weeks Placebo: 1 Placebo Pill per day
Active GLP-1
Change in Fasting Active GLP-1
1.45 pmol/L
Standard Deviation 2.59
-0.22 pmol/L
Standard Deviation 0.88
Active GLP-1
Change in Peak Active GLP-1
22.08 pmol/L
Standard Deviation 15.46
2.97 pmol/L
Standard Deviation 10.44

Adverse Events

Sitagliptin Phosphate

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Blandine Laferrere

Columbia University Medical Center

Phone: 212-851-5562

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place