Evidence map›Paper›PMID 24965545›Full record

Trial reportObesity surgery2014

Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for the treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect.

Wei-Jei Lee, Keong Chong, Yu-Hung Lin, Jih-Hua Wei, Shu-Chun Chen

Abstract readComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Obesity surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 22 pooled it
15.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 22 syntheses or guidelines pooled it, 167 citations in OpenAlex.

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23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Wei-Jei LeeDepartment of Surgery, Min-Sheng General Hospital, No. 168, Chin Kuo Road, Taoyuan, Taiwan, wjlee_obessurg_tw@yahoo.com.tw.
Keong Chong
Yu-Hung Lin
Jih-Hua Wei
Shu-Chun Chen
Min Sheng General Hospital · TWChang Gung University · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBariatric surgery may be beneficial in mildly obese patients with poorly controlled diabetes. The optimal procedure to achieve diabetes remission is unknown. In 2011, we published the short-term results of a pilot study designed to evaluate the efficacy of diabetic control and the role of duodenal exclusion in mildly obese diabetic patients undergoing laparoscopic sleeve gastrectomy (SG) vs. a laparoscopic single anastomosis (mini-) gastric bypass (SAGB). This study analyzes the 5-year results and evaluates the incretin effect.

methodsA double-blind randomized trial included 60 participants with a hemoglobin A1c (HbA1c) level higher than 7.5%, a body mass index (BMI) between 25 and 35 Kg/m(2), a C-peptide level ≥1.0 ng/mL, and a diagnosis of type 2 diabetes mellitus (T2DM) for at least 6 months. A SAGB with duodenal exclusion or a SG without duodenal exclusion was performed.

resultsThe 5-year results of the primary outcome were as an intention-to-treat analysis for HbA1c ≤6.5% without glycemic therapy. Assessments of the incretin effect and β cell function were performed at baseline and between 36 and 60 months. The patients were randomly assigned to SAGB (n = 30) and SG (n = 30). At 60 months, 18 participants (60%; 95% confidence interval (CI), 42 to 78%) in the SAGB group and nine participants (30%; 95% CI, 13 to 47%) in the SG group achieved the primary end points (odds ratio (OR), 0.3; 95% CI, 0.1 to 0.8%). The participants assigned to the SAGB procedure had a similar percentage of weight loss as the SG patients (22.8 ± 5.9 vs. 20.1 ± 5.3%; p > 0.05) but achieved a lower level of HbA1c (6.1 ± 0.7 vs. 7.1 ± 1.2 %; p < 0.05) than the SG patients. There was a significant increase in the incretin effect before and after surgery in both groups, but the SAGB group had a higher incretin effect than the SG group at 5 years.

conclusionsIn mildly obese patients with T2DM, SG is effective at improving glycemic control at 5 years, but SAGB was more likely to achieve better glycemic control than SG and had a higher incretin effect compared to SG.

Indexed as

AdultBlood GlucoseBody Mass IndexDiabetes Mellitus, Type 2Double-Blind MethodFemaleGastrectomyGastric BypassGlucose Clamp TechniqueGlucose Tolerance TestGlycated HemoglobinHumansInsulinInsulin ResistanceInsulin-Secreting CellsLaparoscopyBlood GlucoseGlycated HemoglobinInsulin

Identifiers

PMID24965545
OpenAlexW2009033739

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.