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A Study to Examine Changes in GIP Plasma Levels Following Gastric Bypass Surgery in Obese Patients
This study has been suspended.
First Received: September 13, 2005   Last Updated: November 15, 2005   History of Changes
Sponsored by: Boston Medical Center
Information provided by: Boston Medical Center
ClinicalTrials.gov Identifier: NCT00207389
  Purpose

Obesity is a multinational epidemic. There is evidence that despite educational measures and increased public awareness, the number of obese individuals continues to increase. Of the numerous obesity-related comorbidities, type 2 diabetes remains one of the most significant in terms of mortality and health care costs. Gastric Bypass Surgery (GBS) not only offers an effective form of therapy for morbid obesity, but also amelioration of type 2 diabetes mellitus. The normalization of glucose levels in GBS patients occurs within days after surgery and has been shown in surgical literature to be independent of the weight loss after surgery. The proximal gut, the site of release of certain incretins, may play a role in glucose homeostasis in obese individuals with type 2 diabetes mellitus. One such incretin is GIP, which when released into the circulation during the immediate postprandial period, accentuates the insulin response to a glucose meal. It is hypothesized that overactivity of this enteroinsular axis in obese individuals produces cell resistance to insulin and subsequent type 2 diabetes mellitus. A previous study reported elevated fasting GIP levels, as well as an exaggerated GIP response to a glucose meal, in obese subjects, which was significantly reduced months after GBS following weight loss. This pilot study of obese patients scheduled for GBS will compare the serum levels of certain peptides, including GIP, following a glucose meal before and after GBS, before weight loss has occured. In order to reproduce the preoperative state, and therefore to demonstrate the physiologic change, a small group of subjects who undergo open surgery will undergo the same measurements after surgery, but using a model in which the meal traverses the stomach, duodenum and jejunum with the aid of a gastrostomy tube.


Condition Intervention
Obesity
Type 2 Diabetes Mellitus
Insulin Resistance
Procedure: Oral glucose tolerance test
Procedure: G tube glucose tolerance test

MedlinePlus related topics: Diabetes Obesity Surgery
Drug Information available for: Dextrose
U.S. FDA Resources
Study Type: Interventional
Study Design: Diagnostic, Non-Randomized, Open Label, Uncontrolled, Parallel Assignment, Efficacy Study
Official Title: A Pilot Study to Examine the Relationship Between Changes in Plasma GIP Levels and Other Gastrointestinal Peptides Following Gastric Bypass Surgery in Obese Patients

Further study details as provided by Boston Medical Center:

Primary Outcome Measures:
  • GIP area under the curve after OGTT

Secondary Outcome Measures:
  • Other GI peptides and hormones after OGTT

Estimated Enrollment: 30
Study Start Date: March 2004
Estimated Study Completion Date: March 2005
  Show Detailed Description

  Eligibility

Ages Eligible for Study:   21 Years to 64 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients 21-64 years of age
  • Obese (defined as a body mass index, BMI, > or = 30)
  • Type 2 diabetes or impaired glucose tolerance
  • Have been selected and scheduled for gastric bypass surgery.

Exclusion Criteria:

  • Substance abuse
  • Consumption of more than two alcoholic drinks per day
  • Use of more than 20 units of insulin (any brand or type) per day
  • Fasting blood glucose >180mg/dl on screening bloodwork.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00207389

Locations
United States, Massachusetts
Boston University Medical Center
Boston, Massachusetts, United States, 02118
Sponsors and Collaborators
Boston Medical Center
Investigators
Principal Investigator: Caroline Apovian, MD Boston University Medical Cneter
Principal Investigator: Michael Wolfe, MD Boston University
Study Chair: Marie Mcdonnell, MD Boston University
Study Chair: Harmony Allison, MD Boston University
  More Information

Publications:
MCINTYRE N, HOLDSWORTH CD, TURNER DS. NEW INTERPRETATION OF ORAL GLUCOSE TOLERANCE. Lancet. 1964 Jul 4;41:20-1. No abstract available.
Miyawaki K, Yamada Y, Ban N, Ihara Y, Tsukiyama K, Zhou H, Fujimoto S, Oku A, Tsuda K, Toyokuni S, Hiai H, Mizunoya W, Fushiki T, Holst JJ, Makino M, Tashita A, Kobara Y, Tsubamoto Y, Jinnouchi T, Jomori T, Seino Y. Inhibition of gastric inhibitory polypeptide signaling prevents obesity. Nat Med. 2002 Jul;8(7):738-42. Epub 2002 Jun 17.
Bayliss WM, Starling EH. Croonian lecture. The chemical regulation of the secretory process. Proc R Soc Lond 1904(73):310-332.
GREGORY RA, TRACY HJ. THE CONSTITUTION AND PROPERTIES OF TWO GASTRINS EXTRACTED FROM HOG ANTRAL MUCOSA. Gut. 1964 Apr;46:103-14. No abstract available.
Jorpes E, Mutt V. Cholecystokinin and pancreozymin, one single hormone? Acta Physiol Scand. 1966 Jan-Feb;66(1):196-202. No abstract available.
Kosaka T, Lim RKS. Demonstration of the humoral agent in fat inhibited gastric secretion. Proc Soc Exp Biol Med 1930;27:890-891.
Brown JC, Pederson RA, Jorpes E, Mutt V. Preparation of highly active enterogastrone. Can J Physiol Pharmacol. 1969 Jan;47(1):113-4. No abstract available.
Cleator IG, Gourlay RH. Release of immunoreactive gastric inhibitory polypeptide (IR-GIP) by oral ingestion of food substances. Am J Surg. 1975 Aug;130(2):128-35. No abstract available.
Villar HV, Fender HR, Rayford PL, Bloom SR, Ramus NI, Thompson JC. Suppression of gastrin release and gastric secretion by gastric inhibitory polypeptide (GIP) and vasoactive intestinal polypeptide (VIP). Ann Surg. 1976 Jul;184(1):97-102.
Arnold R, Ebert R, Creutzfeldt W, H.D. B, Börger H. Inhibition of gastric acid secretion by gastric inhibitory polypeptide (GIP) in man. Scand J Gastroenterol 1978;13(Suppl 48):11.

Study ID Numbers: H-22610
Study First Received: September 13, 2005
Last Updated: November 15, 2005
ClinicalTrials.gov Identifier: NCT00207389     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by Boston Medical Center:
Incretins:GIP , GLP-1
Gastric bypass surgery
Laparascopic gastric bypass surgery
Postprandial expression of GIP

Study placed in the following topic categories:
Obesity
Metabolic Diseases
Diabetes Mellitus
Endocrine System Diseases
Overweight
Glucagon-Like Peptide 1
Body Weight
Hyperinsulinism
Signs and Symptoms
Diabetes Mellitus, Type 2
Incretins
Nutrition Disorders
Overnutrition
Endocrinopathy
Insulin Resistance
Glucose Metabolism Disorders
Metabolic Disorder

Additional relevant MeSH terms:
Obesity
Metabolic Diseases
Diabetes Mellitus
Endocrine System Diseases
Overweight
Body Weight
Hyperinsulinism
Signs and Symptoms
Diabetes Mellitus, Type 2
Nutrition Disorders
Overnutrition
Insulin Resistance
Glucose Metabolism Disorders

ClinicalTrials.gov processed this record on May 07, 2009