Impact of Per Oral Pyloromyotomy (POP) on Glycemic Control in Diabetes

NCT ID: NCT04696159

Last Updated: 2025-07-24

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

RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-04

Study Completion Date

2027-06-30

Brief Summary

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This study will assess changes in glycemic control in 40 patients with diabetes who undergo per-oral pyloromyotomy (POP) for medically refractory gastroparesis.

Detailed Description

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This will be a prospective study using HbA1c values and continuous glucose monitoring (CGM) to assess changes in glycemic control in patients with diabetes who undergo per-oral pyloromyotomy (POP) for medically refractory gastroparesis. The study cohort will consist of 40 patients with poor glycemic control who undergo POP. The investigators propose a prospective cohort study using CGM to compare glycemic profiles before and after POP in patients with diabetic gastroparesis. The investigators hypothesize that patients will have improvement in glycemic control and reduced variation in blood glucose levels (% time in hypo/hyperglycemia) after undergoing POP. These results will aid in clinical decision making, and may indicate an earlier need for endoscopic intervention in patients with uncontrolled diabetes and gastroparesis.

Conditions

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Diabetes Mellitus Gastroparesis With Diabetes Mellitus Gastroparesis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Endoscopic Per-Oral Pyloromyotomy (POP)

The study cohort will include 40 patients with a HbA1c \>7.5% with medically refractory gastroparesis who are scheduled to undergo POP. Each patient will undergo two 10-day periods of CGM at an interval of approximately seven months, one month prior to the procedure and six months after. Symptoms and diabetes management improvement will be measured by the Gastroparesis Cardinal Symptom Index (GCSI) scores and the Diabetes Self-Management Questionnaire (DSMQ).

Group Type EXPERIMENTAL

Pyloromyotomy

Intervention Type PROCEDURE

Endoscopic Per-Oral Pyloromyotomy (POP)

Interventions

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Pyloromyotomy

Endoscopic Per-Oral Pyloromyotomy (POP)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patients 18 years of age and older
2. Patients with gastroparesis with an average HbA1c\> 7.5% over the past 3 months
3. Patient that have a diagnosis of gastroparesis established by documented delayed gastric emptying by either a wireless motility capsule study or a nuclear gastric emptying study, with no evidence of gastric obstruction.
4. Patients are able to complete all study requirements

Exclusion Criteria

1. Patients \<18 years of age
2. Patients with gastroparesis with an average HbA1c\< 7.5% over the past 3 months
3. Patients unable or refuse to complete the study requirements
4. Patients who are unable or refuse to wear a CGM sensor
5. Patients with insulin pumps
6. Patients who already use a CGM
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Society of American Gastrointestinal and Endoscopic Surgeons

OTHER

Sponsor Role collaborator

Matthew Allemang

OTHER

Sponsor Role lead

Responsible Party

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Matthew Allemang

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Mathew Allemang, MD

Role: PRINCIPAL_INVESTIGATOR

The Cleveland Clinic

Locations

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Cleveland Clinic Foundation

Cleveland, Ohio, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Deanne Nash, RN

Role: CONTACT

216-445-0953

Facility Contacts

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Mathew Allemang, MD

Role: primary

216 491-7861

References

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Jung HK, Choung RS, Locke GR 3rd, Schleck CD, Zinsmeister AR, Szarka LA, Mullan B, Talley NJ. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009 Apr;136(4):1225-33. doi: 10.1053/j.gastro.2008.12.047. Epub 2008 Dec 24.

Reference Type BACKGROUND
PMID: 19249393 (View on PubMed)

Rodriguez J, Strong AT, Haskins IN, Landreneau JP, Allemang MT, El-Hayek K, Villamere J, Tu C, Cline MS, Kroh M, Ponsky JL. Per-oral Pyloromyotomy (POP) for Medically Refractory Gastroparesis: Short Term Results From the First 100 Patients at a High Volume Center. Ann Surg. 2018 Sep;268(3):421-430. doi: 10.1097/SLA.0000000000002927.

Reference Type BACKGROUND
PMID: 30004920 (View on PubMed)

Ramzan Z, Duffy F, Gomez J, Fisher RS, Parkman HP. Continuous glucose monitoring in gastroparesis. Dig Dis Sci. 2011 Sep;56(9):2646-55. doi: 10.1007/s10620-011-1810-z. Epub 2011 Jul 7.

Reference Type BACKGROUND
PMID: 21735078 (View on PubMed)

Tanenberg RJ, Pfeifer MA. Continuous glucose monitoring system: a new approach to the diagnosis of diabetic gastroparesis. Diabetes Technol Ther. 2000;2 Suppl 1:S73-80. doi: 10.1089/15209150050214168. No abstract available.

Reference Type BACKGROUND
PMID: 11469637 (View on PubMed)

Bailey TS, Chang A, Christiansen M. Clinical accuracy of a continuous glucose monitoring system with an advanced algorithm. J Diabetes Sci Technol. 2015 Mar;9(2):209-14. doi: 10.1177/1932296814559746. Epub 2014 Nov 3.

Reference Type BACKGROUND
PMID: 25370149 (View on PubMed)

Role of Continuous Glucose Monitoring in Diabetes Treatment. Arlington (VA): American Diabetes Association; 2018 Aug. Available from http://www.ncbi.nlm.nih.gov/books/NBK538971/

Reference Type BACKGROUND
PMID: 30958664 (View on PubMed)

Related Links

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http://www-ncbi-nlm-nih-gov.ccmain.ohionet.org/pmc/articles/PMC3722580/

Clinical Guideline: Management of Gastroparesis \[Internet\]. \[cited 2019 Aug 22\].

Other Identifiers

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19-1460

Identifier Type: -

Identifier Source: org_study_id

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