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Bariatric Surgery and Reactive Hypoglycemia

This study has been completed.
Information provided by (Responsible Party):
Geltrude Mingrone, Catholic University of the Sacred Heart Identifier:
First received: April 19, 2012
Last updated: February 4, 2017
Last verified: February 2017

Bariatric surgery has long been recognized as an effective treatment for grade 3 or grade 2 obesity associated with complications. Among the bariatric surgical procedures, roux-en-y gastric bypass (RYGB) was shown to account for 41% of all bariatric operations at least in the United Sates. Sleeve gastrectomy (SG), that was conceived as the first step before performing a RYGB or a biliopancreatic diversion with duodenal switch in patients who were super-obese, has recently emerged as a new restrictive bariatric procedure.

Reactive hypoglycemia is a late complication affecting up to 72% of RYGB patients although it seems to occur also after SG, in about 3% of the cases. However, until now no prospective studies have investigated the incidence of hypoglycemia after RYGB nor randomized studies have been undertaken to compare the effect of SG to that of RYGB in terms of incidence of hypoglycemic episodes.

The primary aim of the present study is to conduct a 1-year randomized trial to compare the incidence of hypoglycemia after RYGB or SG.

Condition Intervention
Obesity With Complications Morbid Obesity Reactive Hypoglycemia Bariatric Surgery Procedure: Gastric Bypass Procedure: Sleeve Gastrectomy

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment

Resource links provided by NLM:

Further study details as provided by Geltrude Mingrone, Catholic University of the Sacred Heart:

Primary Outcome Measures:
  • incidence reactive hypoglycemia [ Time Frame: up to 12 months ]
    The Primary Endpoint of the study is the incidence reactive hypoglycemia within 1 year after the bariatric surgery.

Secondary Outcome Measures:
  • insulin resistance [ Time Frame: 0,1,3,6,9, and 12 months ]

    Changes at 1 year of insulin sensitivity and insulin secretion measured after an OGTT.

    Changes at 1 year of body weight, BMI, abdominal circumference, body composition, lipid profile and cardiovascular system abnormalities.

    the incidence of severe hypoglycemia or related symptoms (shakiness, sweating, dizziness or light-headedness, confusion, difficulty speaking, weakness, confusion, syncope, epilepsy, seizures) within 5 years after the operation.

Enrollment: 120
Study Start Date: October 2012
Study Completion Date: March 2016
Primary Completion Date: March 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Gastric Bypass
60 subjects obese subjects with complications or morbidly obese subjects will be assigned randomly to this arm to undergo gastric bypass
Procedure: Gastric Bypass

Roux-en-Y Gastric Bypass This laparoscopic operation includes the division of the stomach in two parts. A proximal, smaller pouch (20-25 cc volume), is connected to the rest of the gastrointestinal tract through a gastro-jejunal anastomosis, whereas the distal gastric pouch is left behind but excluded from the transit of food.

An entero-entero anastomosis, with a Roux-en-Y type of reconstruction, allows the bile and pancreatic juices to mix with the nutrients at about 100-150 cm from the gastro-jejunal connection.

Sleeve Gastrectomy
60 subjects obese subjects with complications or morbidly obese subjects will be assigned randomly to this arm to undergo sleeve gastrectomy
Procedure: Sleeve Gastrectomy
Sleeve gastrectomy Laparoscopic SG involves a longitudinal resection of the stomach on the greater curvature from the antrum starting opposite of the nerve of Latarjet up to the angle of His The final gastric volume is about 100 mL.

  Show Detailed Description


Ages Eligible for Study:   25 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients are eligible if aged between 25 and 65 years, have a body mass index of 35 (in presence of complications as sleep apnea, severe coxarthritis or gonarthritis, severe hypertension) to 50 kg/m2, and are able to understand and comply with the study process.

Exclusion Criteria:

  • History of type 1 diabetes or secondary diabetes;
  • Previous bariatric surgery;
  • History of medical problems such as mental impairment;
  • Major cardiovascular disease;
  • Major gastrointestinal disease;
  • Major respiratory disease;
  • Hormonal disorders;
  • Infection;
  • History of drug addiction and/or alcohol abuse;
  • Internal malignancy;
  • Pregnancy;
  • Impaired glucose tolerance;
  • Suspected or confirmed poor compliance;
  • Informed consents.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01581801

Catholic University School of Medicine
Rome, Italy, 00168
Sponsors and Collaborators
Catholic University of the Sacred Heart
Principal Investigator: Geltrude Mingrone, MD Catholic University, Italy
  More Information


Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Geltrude Mingrone, Associate Professor of Internal Medicine, Catholic University of the Sacred Heart Identifier: NCT01581801     History of Changes
Other Study ID Numbers: UCSC-2012-V01
2012-bariatric-001 ( Other Identifier: Catholic University )
Study First Received: April 19, 2012
Last Updated: February 4, 2017

Keywords provided by Geltrude Mingrone, Catholic University of the Sacred Heart:
gastric bypass
sleeve gastrectomy
reactive hypoglycemia

Additional relevant MeSH terms:
Obesity, Morbid
Nutrition Disorders
Body Weight
Signs and Symptoms
Glucose Metabolism Disorders
Metabolic Diseases processed this record on September 21, 2017