Analysing Differences in Glycaemic Control Immediately Post Obesity SurgEry (The ADIPOSE Study) (ADIPOSE)

This study has been terminated.

(Slow recruitment and sufficient data available to analyse)

Sponsor:

ClinicalTrials.gov Identifier:

NCT01515059

First Posted: January 23, 2012

Last Update Posted: December 15, 2015

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Collaborator:

University Hospitals, Leicester

Information provided by (Responsible Party):

University of Leicester

Purpose

It is well established that bariatric (weightloss) surgery affords considerable improvement in glycaemic control (control of blood sugar), and in many cases may lead to a complete resolution of type 2 diabetes. However, the mechanisms underlying these changes are yet to be elucidated and no research project to date has attempted to characterise changes in glycaemic control sooner than 3 days post surgery.

The primary objective of this study is to characterise changes in glycaemic control in individuals immediately following such surgery for a period of five days. Participants will be fitted with a continuous blood glucose measurement system (CGMS) prior to leaving theatre, which electronically records their blood glucose concentration every minute for up to five days. Upon returning the device each participant will undergo a standard meal test and have a small blood sample taken at 30 minute intervals (0-120 minutes) for the quantification of incretins (gut hormones involved in medium term control of blood sugar) insulin, glucose and appetite hormones.

These measurements will be compared to those collected at the baseline session, three weeks prior to the patient's surgery. Additional baseline visit measurements include: fasting lipid profile, insulin concentration, blood glucose concentration, HBA1C (long term blood glucose measurement), blood pressure, height, weight, waist circumference, and an oral glucose tolerance test (OGTT) and medical and family history.

All patients will be followed up twelve weeks post surgery, during which, all baseline measurements will be repeated.

Condition
Obesity


Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	A Prospective Pilot Study Investigating the Effects of Bariatric Surgery on Measures of Glycaemic Control and Incretin Levels

Further study details as provided by University of Leicester:

Primary Outcome Measures:

Glycaemic shift [ Time Frame: Baseline - 12 weeks post surgery ]
The primary outcome is time taken for a glycaemic shift to be observed, as measured by CGMS. This is the mean proportion (%) of time spent either above (≥10mmol/l), below (≤3.1mmol/l) or within (3.2-9.9mmol/l) our predefined glycaemic ranges will be calculated for each participant over the recording period and adjusted for 24 hours. A glycaemic shift in this context is defined as a statistically (p<0.05) significant reduction or increase in the proportion of time spent within a glycaemic range i.e. shift from hyperglycaemic to normoglycaemic range.

Secondary Outcome Measures:

Change in number of hyperglycaemic events [ Time Frame: Baseline to 12 weeks post surgery ]
The time taken for a change in the number of hyperglycaemic events (≥ 10.0 mmol/l for a duration of ≥ 10 minutes) to
Change in duration of hyperglycaemic events [ Time Frame: Baseline to 12 weeks post surgery ]
The time taken for a change in the duration of hyperglycaemic events (minutes) to be observed
Change in number of hypoglycaemic events [ Time Frame: Baseline to 12 weeks post surgery ]
The time taken for a change in the number of hypoglycaemic events (≤ 3.1 mmol/l for a duration of ≥ 10 minutes) to be observed (adjusted for 24 hours)
Change in duration of hypoglycaemic events [ Time Frame: Baseline to 12 weeks post surgery ]
The time taken for a change in the duration of hypoglycaemic event (minutes) to be observed
Change in GLP-1 Profile [ Time Frame: Baseline to 12 weeks post surgery ]
The change in the area under the curve of the GLP1 profile between visit 1 and 2
Change in GIP profile [ Time Frame: Baseline to 12 weeks post surgery ]
The change in the fasting levels GIP between visit 1-2 and 2-3
Change in insulin profile [ Time Frame: Baseline to 12 weeks post surgery ]
The change in the fasting levels of insulin between visit 1-2 and 2-3
Change in HbA1c [ Time Frame: Baseline to 12 weeks post surgery ]
The change in Hba1c between visit 1 and 3
Change in FPG [ Time Frame: Baseline to 12 weeks post surgery ]
The change in fasting glucose levels between visit 1 and 3
Change in 2h glucose [ Time Frame: Baseline to 12 weeks post surgery ]
The change in 2 hour post load glucose levels between visit 1 and 3
Change in MAGE [ Time Frame: Baseline to 12 weeks post surgery ]
The change in mean amplitude of glycaemic excursions (MAGE) between visit 1 and 3
Change in subjective appetite [ Time Frame: Baseline to 12 weeks post surgery ]
The change in subjective appetite between visit 1 - 3 and over the course of the hospital stay
Change in subjective palatability [ Time Frame: Baeline to 12 weeks post sugery ]
The change in subjective palatability of meal test between visit 1 and 3
Change in appetite via VAS [ Time Frame: Baseline to 12 weeks post surgery ]
The change in appetite as measured via visual analogue scale between visits 1 and 3 and change throughout inpatient stay.
Change in palatability via VAS [ Time Frame: Baseline to 12 weeks post surgery ]
The change in palatability as measured via visual analogue scale


Enrollment:	16
Study Start Date:	September 2012
Study Completion Date:	December 2015
Primary Completion Date:	December 2015 (Final data collection date for primary outcome measure)

Groups/Cohorts
Bariatric sugery patients Obese patients who are awaiting either a gastric bypass or sleeve gastrectomy

Show Detailed Description

Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:	18 Years to 75 Years (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No
Sampling Method:	Non-Probability Sample

Study Population

20 successive obese patients who are awaiting either a gastric bypass or sleeve gastrectomy

Criteria

Inclusion Criteria:

18 years of age or older
No active psychotic illness
On the waiting list for bariatric surgery at the Leicester Royal Infirmary and thus meeting the local eligibility criteria for this procedure

Exclusion Criteria:

< 18 years of age
Pregnant
Active psychotic illness
Receiving either GLP1 analogue or DPPIV inhibitor therapy
History of dug or alcohol dependancy
History of poorly controlled/severe mental health problems
Presence of any comorbidities contraindicative of abdominal surgery or anaesthesia (American Society of Anaesthesiology grade 4, certain grade 3)

Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01515059

Locations


United Kingdom
Leicester Diabetes Centre
Leicester, Leicestershire, United Kingdom, LE5 4PW

Sponsors and Collaborators

University of Leicester

University Hospitals, Leicester

Investigators


Principal Investigator:	Melanie Davies, MD	University of Leicester
Principal Investigator:	David Bowrey, MD	Universty Hospitals of Leicester NHS Trust
Principal Investigator:	Kamlesh Khunti, MD	University of Leicester
Principal Investigator:	Patrice Carter, PhD	University of Leicester
Principal Investigator:	Christopher Sutton, MD	University Hospitals, Leicester
Principal Investigator:	Laura Gray, PhD	University of Leicester
Principal Investigator:	Emer Brady, PhD	University Hospitals, Leicester

More Information


Responsible Party:	University of Leicester
ClinicalTrials.gov Identifier:	NCT01515059 History of Changes
Other Study ID Numbers:	11/EM/0463
First Submitted:	January 18, 2012
First Posted:	January 23, 2012
Last Update Posted:	December 15, 2015
Last Verified:	December 2015

Keywords provided by University of Leicester:


obesity diabetes bariatric surgery gastric bypass insulin	glucose incretins leptin ghrelin

Additional relevant MeSH terms:


Obesity Overnutrition Nutrition Disorders Overweight Body Weight	Signs and Symptoms Incretins Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs

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