Prospective Controlled Trial on Surgical Treatment of Type 2 Diabetes Patients With BMI 25-30 by Means of Biliopancreatic Diversion (DIA-BPD 25-30)
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Purpose
A previous prospective study of BPD effect on type 2 diabetes patients with BMI 25-35 (DIA-CHIR) showed that T2DM is less sensitive to BPD beneficial effect in the simply overweight patients. A new prospective study was then planned with the aim to gain insight in the mechanism of action of BPD in T2DM patients in the 25-30 BMI range. Thirty patients will be submitted to BPD and compared with 10 nonoperated controls. Euglycemic-hyperinsulinemic clamp, OGTT, and mixed meal test will be performed in all subjects preoperatively, and 1 month, 1 year, and 5 years after BPD. Complete clinical and biochemical evaluations will be performed at 1, 4, 8, and 12 months, and every sixth month thereafter until the end of the fifth year.
| Condition | Intervention | Phase |
|---|---|---|
|
Type 2 Diabetes Mellitus Bariatric Surgery Biliopancreatic Diversion |
Procedure: biliopancreatic diversion Drug: antidiabetics |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Prospective Controlled Trial on Surgical Treatment of Type 2 Diabetes Patients With BMI 25-30 by Means of Biliopancreatic Diversion |
- Diabetes control as defined by FSG and HbA1c [ Time Frame: 1 year ] [ Designated as safety issue: No ]
- Diabetes control as defined by FSG and HbA1c [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Assessment of prevalence and severity of diabetes complications [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
- Assessment of patient BMI [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 40 |
| Study Start Date: | July 2009 |
| Estimated Study Completion Date: | December 2016 |
| Estimated Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: surgery
biliopancreatic diversion
|
Procedure: biliopancreatic diversion
biliopancreatic diversion consists of a distal gastrectomy with a long Roux-en-Y reconstruction, where the enteroenterostomy is placed 50 cm proximal to the ileocecal valve
|
|
Active Comparator: standard medical care
patients treated according to the rules of good clinical practice
|
Drug: antidiabetics
patients are treated with conventional antidiabetic drugs according to the rules of good clinical practice
|
Eligibility| Ages Eligible for Study: | 35 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age: 35-70 years
- diabetes duration: >5 years
- documented poor glycemic control (HbA1c =>8% despite medical treatment according to GCP)
- presence of comorbidities or complications (e.g. dyslipidemia, arterial hypertension, neuropathy, retinopathy, CVD, previous stroke or TIA, lower limb amputation)
- availability to comply with the entire follow-up
Exclusion Criteria:
- general contraindications to BPD (applies also to medical controls)
- presence of anti-islet or anti-GAD antibodies or plasma C-peptide concentration <0.5 mcg/L
- blindness
- severe concomitant medical conditions (e.g. liver cirrhosis, renal failure, collagen diseases, severe endocrinopathies)
- heart failure
- recent history (less than 12 months) of myocardial infarction, stroke or TIA
- unstable angina
- pregnancy
- previous or concomitant malignancy
- severe active inflammatory, neurologic, or cardiovascular conditions
- geographic inaccessibility
- any condition which, in the opinion of the Principal Investigator, may make risky the participation in the study or bias the results
Contacts and Locations| Contact: Nicola Scopinaro, MD | +39 010 3537301 | nicola.scopinaro@unige.it |
| Italy | |
| Ospedale San Martino | Recruiting |
| Genova, Italy, 16132 | |
| Contact: Nicola Scopinaro, MD +39 010 3537301 nicola.scopinaro@unige.it | |
| Principal Investigator: Nicola Scopinaro, MD | |
More Information
No publications provided
| Responsible Party: | Nicola Scopinaro, Professor of Surgery, Azienda Ospedaliera Universitaria San Martino |
| ClinicalTrials.gov Identifier: | NCT01046994 History of Changes |
| Other Study ID Numbers: | DIA-BPD |
| Study First Received: | January 11, 2010 |
| Last Updated: | January 11, 2010 |
| Health Authority: | Italy: Comitato Etico dell'Azienda Ospedaliera Universitaria "San Martino" |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases |
Endocrine System Diseases Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 18, 2013