Weight Loss-Independent Metabolic Effects of Roux-En-Y Gastric Bypass in Diabetes

NCT ID: NCT02207777

Last Updated: 2025-07-20

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

NA

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-08-31

Study Completion Date

2019-03-31

Brief Summary

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For this purpose, we will compare the effects of targeted 16-18% (with a range of 16-25%) weight loss induced by Roux-en-Y Gastric bypass (RYGB) surgery with the same weight loss induced by a low-calorie diet (LCD) on liver and skeletal muscle insulin sensitivity, beta-cell function, and 24-hour metabolic homeostasis in obese subjects with or without T2D.

Detailed Description

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Conditions

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Obesity Type 2 Diabetes

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Roux-en-Y gastric bypass (RYGB)

Subjects in this group are scheduled to undergo roux-en-Y gastric bypass surgery to obtain approximately 16-18% (with a range of 16-25%) weight loss.

Group Type EXPERIMENTAL

Roux-en-Y gastric bypass surgery

Intervention Type PROCEDURE

A surgical procedure to help subjects lose approximately 16-18% (with a range of 16-25%) of their body weight.

Low-calorie diet

Subjects in this group will participate in a low-calorie diet intervention to obtain approximately 16-18% (with a range of 16-25%) weight loss.

Group Type ACTIVE_COMPARATOR

Low-calorie diet

Intervention Type BEHAVIORAL

Subjects will meet with a dietitian and/or behaviorist over approximately 6 months to lose approximately 16-18% (with a range of 16-25%) of their body weight.

Interventions

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Roux-en-Y gastric bypass surgery

A surgical procedure to help subjects lose approximately 16-18% (with a range of 16-25%) of their body weight.

Intervention Type PROCEDURE

Low-calorie diet

Subjects will meet with a dietitian and/or behaviorist over approximately 6 months to lose approximately 16-18% (with a range of 16-25%) of their body weight.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

For RYGB group:

* Scheduled for this bariatric surgery
* Body Mass Index (BMI) 34-55 kg/m²
* Type 2 Diabetes
* Signed informed consent

For Low-Calorie Diet group:

* BMI 34-55 kg/m²
* Type 2 Diabetes and Non-Diabetics
* Signed informed consent

Exclusion Criteria

For both RYGB \& Low-Calorie Diet groups

* Regular use of tobacco products
* Previous intestinal resection
* Pregnant or breastfeeding
* Evidence of significant organ system dysfunction or disease other than T2D
* Use of any medication that might, in the opinion of the investigator, affect metabolic function
* Exercise ≥90 minutes per week
Minimum Eligible Age

25 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

Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Samuel Klein, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Countries

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United States

References

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Petersen MC, Yoshino M, Smith GI, Gaspar RC, Kahn M, Samovski D, Shulman GI, Klein S. Effect of Weight Loss on Skeletal Muscle Bioactive Lipids in People With Obesity and Type 2 Diabetes. Diabetes. 2024 Dec 1;73(12):2055-2064. doi: 10.2337/db24-0083.

Reference Type BACKGROUND
PMID: 39264820 (View on PubMed)

Samovski D, Smith GI, Palacios H, Pietka T, Fuchs A, Patti GJ, Nawaz A, Kahn CR, Klein S. Effect of Marked Weight Loss on Adipose Tissue Biology in People With Obesity and Type 2 Diabetes. Diabetes Care. 2025 Aug 1;48(8):1342-1351. doi: 10.2337/dc24-2739.

Reference Type BACKGROUND
PMID: 40208704 (View on PubMed)

Smith GI, Klein S. Plasma endotrophin levels correlate with insulin resistance in people with obesity. J Clin Invest. 2025 Apr 22;135(12):e190577. doi: 10.1172/JCI190577. eCollection 2025 Jun 16. No abstract available.

Reference Type BACKGROUND
PMID: 40261704 (View on PubMed)

Yoshino M, Kayser BD, Yoshino J, Stein RI, Reeds D, Eagon JC, Eckhouse SR, Watrous JD, Jain M, Knight R, Schechtman K, Patterson BW, Klein S. Effects of Diet versus Gastric Bypass on Metabolic Function in Diabetes. N Engl J Med. 2020 Aug 20;383(8):721-732. doi: 10.1056/NEJMoa2003697.

Reference Type BACKGROUND
PMID: 32813948 (View on PubMed)

van Vliet S, Koh HE, Patterson BW, Yoshino M, LaForest R, Gropler RJ, Klein S, Mittendorfer B. Obesity Is Associated With Increased Basal and Postprandial beta-Cell Insulin Secretion Even in the Absence of Insulin Resistance. Diabetes. 2020 Oct;69(10):2112-2119. doi: 10.2337/db20-0377. Epub 2020 Jul 10.

Reference Type DERIVED
PMID: 32651241 (View on PubMed)

Other Identifiers

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1R01DK101578

Identifier Type: NIH

Identifier Source: secondary_id

View Link

201403065

Identifier Type: -

Identifier Source: org_study_id

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