Surgical Innovation for Diabetes Treatment

NCT ID: NCT04196348

Last Updated: 2022-09-02

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

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-28

Study Completion Date

2024-08-31

Brief Summary

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This study will determine how two variants of gastric bypass induce changes in dynamic endocrine response in the fasting and post-prandial state, both before and at different time points after the surgical interventions.

This study will monitor the endocrine dynamics after different anatomical modifications produced by Roux-en-Y gastric bypass procedures in diabetic participants and normoglycemic participants, to gain insights into the mechanisms beyond the metabolic improvement after the two surgical variants through participants re-evaluation at different time points.

Detailed Description

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Abstract

Obesity prevalence is a major risk factor for the onset of type 2 diabetes. Diabetic patients are frequently overweight or obese and diabetes complications are the main cause of obesity-related morbimortality, demanding proper and effective clinical management.

Bariatric surgery, originally conceived for obesity treatment, has proven not only to be the most effective weight loss intervention but also for comorbidity management, with a strong impact on type 2 diabetes. As the antidiabetic effects of bariatric surgery largely exceed the metabolic improvement predicted by the caloric restriction and weight loss, which are mostly driven by the enteroendocrine response, this challenges the academic and medical communities with the need to learn how to leverage the enteroendocrine system to achieve glucose homeostasis.

Supported on the investigators' previous work focusing on gastro-intestinal hormones and glucose metabolism after bariatric surgery, the investigators now aim to monitor the intestinal hormone after different anatomical modifications produced by Roux-en-Y gastric bypass procedures in diabetic participants and normoglycemic individuals. The utmost goal will be to unravel the endocrine mechanisms beyond the metabolic improvement observed after the surgical manipulations, towards the identification of novel targets for hormone based treatments in an individualised clinical approach.

Study Overview: Participants in this study will be submitted to either short or long BPL RYGB surgery. Participants visits will be scheduled before surgery and after surgery at 3, 6 and 12 months for detailed participants assessment that will include anthropometric and biochemical evaluation and the performance of a MMTT with plasma sampling for hormonal profiles.

Participant Enrolment: Participants will be selected from the cohort of patients referred for multidisciplinary evaluation by the clinical team for surgical treatment of obesity of the Centro Hospitalar Entre Douro e Vouga (CHEDV). Participants found to be suitable according to the entry criteria and accept to participate will be enrolled in the study and assigned to one of the three study groups according to participants clinical features.

Study Chair: Mário Nora, MD

Principal Investigator: Marta Guimarães, MD, PhD

Conditions

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Obesity Diabetes Mellitus, Type 2

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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Short BPL RYGB in glucose-tolerant participants

Procedure: short biliopancreatic limb (BPL) Roux en Y Gastric Bypass (RYGB) Obese patients without type 2 diabetes mellitus (T2DM) to be submitted to short BPL (n=10)

Group Type ACTIVE_COMPARATOR

Short BPL RYGB

Intervention Type PROCEDURE

Alimentary limb (AL) with 120 cm and BPL with 100 cm.

Long BPL RYGB in glucose-tolerant participants

Procedure: long BPL RYGB Obese patients with metabolic syndrome without T2DM to be submitted to long BPL (n=10)

Group Type ACTIVE_COMPARATOR

Long BPL RYGB

Intervention Type PROCEDURE

AL with 120 cm and BPL with 200 cm.

Long BPL RYGB in diabetic participants

Procedure: long BPL RYGB Obese patients with metabolic syndrome and T2DM to be submitted to long BPL (n=10)

Group Type ACTIVE_COMPARATOR

Long BPL RYGB

Intervention Type PROCEDURE

AL with 120 cm and BPL with 200 cm.

Interventions

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Short BPL RYGB

Alimentary limb (AL) with 120 cm and BPL with 100 cm.

Intervention Type PROCEDURE

Long BPL RYGB

AL with 120 cm and BPL with 200 cm.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* BMI between 35 and 45 kg/m2 with indication for bariatric surgery
* Aged between 18 and 65 years at surgery

Exclusion Criteria

* Unwillingness, inability or intolerance to complete the MMTT (ingest 200 mL in 15 minutes or less)
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto de Ciências Biomédicas Abel Salazar

OTHER

Sponsor Role collaborator

The Novo Nordisk Foundation Center for Basic Metabolic Research

OTHER

Sponsor Role collaborator

Hospital de Sao Sebastiao

OTHER

Sponsor Role lead

Responsible Party

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Marta Guimarães

SURIDIAB-1 Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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São Sebastião Hospital

Santa Maria da Feira, Aveiro District, Portugal

Site Status

Countries

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Portugal

Other Identifiers

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Hsebastião

Identifier Type: -

Identifier Source: org_study_id

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