Evidence mapPaperPMID 25098565Full record

Trial reportObesity surgery2015

Surgical treatment of type 2 diabetes in subjects with mild obesity: mechanisms underlying metabolic improvements.

A C Fellici, G Lambert, M M O Lima, J C Pareja, S Rodovalho, E A Chaim, Bruno Geloneze

Abstract readClinical Trial
PubMed Publisher
In one paragraph

Trial report in Obesity surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
1.2field-weighted citation impact, top 21% 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

12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Physiologic Mechanisms of Type II Diabetes Mellitus Remission Following Bariatric Surgery: a Meta-analysis and Clinical Implications.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
    Pooled it
  3. Pooled it
  4. Review
  5. The Role of Beta Cell Recovery in Type 2 Diabetes Remission.International journal of molecular sciences · 2022
    Review
  6. Article
  7. Article
  8. Metabolic Outcomes of Surgery for Non-Obese Type 2 Diabetes.Journal of minimally invasive surgery · 2020
    Review
  9. Review
  10. DIABETES REMISSION RATE IN DIFFERENT BMI GRADES FOLLOWING ROUX-EN-Y GASTRIC BYPASS.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2018
    Article
  11. Article
  12. Article
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

7 authors at 2 institutions in 1 country.

A C FelliciLaboratory of Investigation in Metabolism and Diabetes (LIMED)/Gastrocentro, State University of Campinas (UNICAMP), R. Carlos Chagas, 420, Cidade Universitária, Campinas, SP, 13081-970, Brazil.
G Lambert
M M O Lima
J C Pareja
S Rodovalho
E A Chaim
Bruno Geloneze
Universidade Estadual de Campinas (UNICAMP) · BRNational Council for Scientific and Technological Development · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aims to assess the clinical and physiological effects of Roux-en-Y gastric bypass (RYGBP) on type 2 diabetes associated with mild obesity (body mass index [BMI] 30-34.9 kg/m(2)) over 24 months postsurgery.

methodsIn this prospective trial, 36 mildly obese subjects (19 males) with type 2 diabetes using oral antidiabetic drugs with (n = 24) or without insulin (n = 12) underwent RYGBP. Follow-up was conducted at baseline and 3, 6, 12, and 24 months postsurgery. The following endpoints were considered: changes in HbA1c, fasting glucose and insulin, antidiabetic therapy, BMI, oral glucose insulin sensitivity [OGIS, from meal tolerance test (MTT)], beta-cell secretory function [ΔCP(0-30)/ΔGlu(0-30) (ΔC-peptide/Δglucose ratio, MTT 0-30 min), disposition index (DI = OGIS [Symbol: see text] ΔCP(0-30)/ΔGlu(0-30)], glucagon-like peptide (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) [incremental area under the curve (AUCi)], adiponectin, C-reactive protein, and lipids.

resultsAll subjects achieved normal-to-overweight BMI after 3 months. Over 24 months, 31/36 (86 %) subjects presented HbA1c <7 % [complete and partial remission of diabetes in 9/36 (22 %) and 1/36 (3 %), respectively]. Since 3 months postsurgery, improvements were observed in OGIS [290 (174) to 373 (77) ml/min/m(2), P = 0.009], ΔCP(0-30)/ΔGlu(0-30) [0.24 (0.19) to 0.52 (0.34) ng/mg, P = 0.001], DI [7.16 (8.53) to 19.8 (15.4) (ng/mg) (ml/min/m(2)), P = 0.001], GLP-1 AUCi [0.56 (0.64) to 3.97 (3.86) ng/dl [Symbol: see text] 10 min [Symbol: see text] 103, P = 0.000], and GIP AUCi [30.2 (12.6) to 27.0 (20.2) ng/dl [Symbol: see text] 10 min [Symbol: see text] 103, P = 0.004]. At baseline and after 12 months, subjects with diabetes nonremission had longer diabetes duration, higher HbA1c, lower beta-cell secretory function, and higher first 30-min GIP AUCi, compared with those with remission.

conclusionsRYGBP improves the glucose metabolism in subjects with type 2 diabetes and mild obesity. This effect is associated with improvement of insulin sensitivity, beta-cell secretory function, and incretin secretion.

Indexed as

Gastric BypassAdultBlood GlucoseBody Mass IndexDiabetes Mellitus, Type 2FemaleGlucagon-Like Peptide 1Glucose Tolerance TestHumansInsulinInsulin ResistanceMaleMiddle AgedObesitySeverity of Illness IndexBlood GlucoseGlucagon-Like Peptide 1Insulin

Identifiers

PMID25098565
OpenAlexW2029614422

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.