Resolution of Type 2 Diabetes Mellitus: Intensive vs. Conventional Glycaemic Control After Obesity Surgery (GLUCOSURG1)
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Purpose
Obesity surgery is very effective in improving or even curing Type 2 Diabetes in patients with obesity. Many patients stop or reduce their medication after surgery and this can happen fairly quickly. The investigators do not know whether strict control of blood glucose/sugar after the operation makes any difference in the long term. Additionally many patients prefer their blood sugars to be a "bit high" because they are afraid of hypos.A number of studies have described patients whose eye, nerve and kidney disease has deteriorated when high sugars are controlled very quickly. The investigators want to ensure that surgery provides maximum benefit and remains safe in patients with diabetes. This study will help us decide if the investigators should be strict with blood glucose after obesity surgery operations or not and whether obesity surgery is safe for the eye, nerve and kidney complications of diabetes.
| Condition | Intervention |
|---|---|
|
Type 2 Diabetes Mellitus Obesity Bariatric Surgery |
Drug: Insulin |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Resolution of Type 2 Diabetes Mellitus: Intensive vs. Conventional Glycaemic Control After Obesity Surgery. |
- Percentage of patients with Type 2 Diabetes Mellitus who achieve fasting blood glucose of less than 5.6 mmol/l and/or HbA1c of less than 6% [ Time Frame: 1 year after surgery ] [ Designated as safety issue: No ]Patients will be tested off all antidiabetes medications if safe to do so
- Percentage of Type 2 Diabetes Mellitus patients with a reduction in the doses/number of diabetes medications used preoperatively [ Time Frame: 1 year after surgery ] [ Designated as safety issue: No ]
- Microvascular events [ Time Frame: 1 year after surgery ] [ Designated as safety issue: Yes ]Composite of microvascular events will be defined as new or worsening nephropathy, retinopathy or neuropathy.
| Estimated Enrollment: | 100 |
| Study Start Date: | December 2010 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Intensive glycaemic control |
Drug: Insulin
All patients will be prescribed insulin glargine once a day. The dose of the insulin will be adjusted to achieve fasting capillary glucose levels between 5-7 in the intensive group and 7-9 mmol/l in the control group.
Other Name: Insulin Glargine
|
| Active Comparator: Conservative glycaemic control |
Drug: Insulin
All patients will be prescribed insulin glargine once a day. The dose of the insulin will be adjusted to achieve fasting capillary glucose levels between 5-7 in the intensive group and 7-9 mmol/l in the control group.
Other Name: Insulin Glargine
|
Detailed Description:
Subjects would be randomised into intensive glycaemic control and conventional glycaemic control after obesity surgery. Data on complications of diabetes such as eye, nerve and kidney will be collected before obesity surgery and 1 year after surgery.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with Type 2 Diabetes Mellitus who have been approved for obesity surgery
Exclusion Criteria:
- Patients with Type 2 Diabetes Mellitus who do not require insulin immediately after obesity surgery
Contacts and Locations| United Kingdom | |
| Imperial College Healthcare NHS Trust | |
| London, United Kingdom, W6 8RF | |
| Principal Investigator: | Carel W le Roux, MRCP, PhD | Imperial College London |
More Information
No publications provided
| Responsible Party: | Carel Le Roux, Consultant metabolic medicine, Imperial College London |
| ClinicalTrials.gov Identifier: | NCT01257087 History of Changes |
| Other Study ID Numbers: | GLUCOSURG1 |
| Study First Received: | December 8, 2010 |
| Last Updated: | January 1, 2013 |
| Health Authority: | United Kingdom: Research Ethics Committee |
Keywords provided by Imperial College London:
|
Type 2 Diabetes Mellitus Obesity Bariatric Surgery Glycaemic control |
Microvascular complications Intensive Conservative |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Obesity Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Overnutrition Nutrition Disorders |
Overweight Body Weight Signs and Symptoms Glargine Insulin Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013