Evidence mapPaperPMID 25901097Full record

Trial reportDiabetes2015

Preserved Insulin Secretory Capacity and Weight Loss Are the Predominant Predictors of Glycemic Control in Patients With Type 2 Diabetes Randomized to Roux-en-Y Gastric Bypass.

Kim T Nguyen, Charles J Billington, Adrian Vella, Qi Wang, Leaque Ahmed, John P Bantle, Marc Bessler, John E Connett, William B Inabnet, Avis Thomas and 2 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
field-weighted citation impact
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

33 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Pooled it
  4. Pooled it
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  20. Changing the Concept of Type 2 Diabetes: Beta Cell Workload Hypothesis Revisited.Endocrine, metabolic & immune disorders drug targets · 2019
    Review
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

12 authors.

Kim T NguyenDivision of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, NY.
Charles J BillingtonDivision of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN.
Adrian VellaDivision of Endocrinology and Diabetes, Department of Medicine, Mayo Clinic, Rochester, MN.
Qi WangDivision of Biostatistics, University of Minnesota, Minneapolis, MN.
Leaque AhmedDepartment of Surgery, Columbia University Medical Center, New York, NY.
John P BantleDivision of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN.
Marc BesslerDepartment of Surgery, Columbia University Medical Center, New York, NY.
John E ConnettDivision of Biostatistics, University of Minnesota, Minneapolis, MN.
William B InabnetDepartment of Surgery, Mount Sinai Medical Center, New York, NY.
Avis ThomasDivision of Biostatistics, University of Minnesota, Minneapolis, MN.
Sayeed IkramuddinDepartment of Surgery, University of Minnesota, Minneapolis, MN.
Judith KornerDivision of Endocrinology, Department of Medicine, Columbia University Medical Center, New York, NY jk181@cumc.columbia.edu.

Funding

TRAINING PROGRAM IN ENDOCRINOLOGY AND METABOLISMT32DK007271 · COLUMBIA UNIV NEW YORK MORNINGSIDE · 1986 to 2005
$1.7M
The regulation of fasting glucose metabolism in people with and without prediabetesR01DK078646 · MAYO CLINIC ROCHESTER · 2025 to 2025
$667k
Bariatric Surgery, Gastric Stimulation: Metabolic EffectsR01DK072011 · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2005 to 2005
$302k
NCATS NIH HHS UL1 TR000040NCATS NIH HHS UL1-TR000040NCATS NIH HHS UL1 TR000114NCRR NIH HHS UL1 RR024156NCRR NIH HHS UL1-RR024156NIDDK NIH HHS DK-072011NIDDK NIH HHS R01 DK072011NIDDK NIH HHS R01 DK078646NIDDK NIH HHS T32 DK007271NIDDK NIH HHS T32-DK-007271-33S1
6 · The paper itself

Abstract

Improvement in type 2 diabetes after Roux-en-Y gastric bypass (RYGB) has been attributed partly to weight loss, but mechanisms beyond weight loss remain unclear. We performed an ancillary study to the Diabetes Surgery Study to assess changes in incretins, insulin sensitivity, and secretion 1 year after randomization to lifestyle modification and intensive medical management (LS/IMM) alone (n = 34) or in conjunction with RYGB (n = 34). The RYGB group lost more weight and had greater improvement in HbA1c. Fasting glucose was lower after RYGB than after LS/IMM, although the glucose area under the curve decreased comparably for both groups. Insulin sensitivity increased in both groups. Insulin secretion was unchanged after LS/IMM but decreased after RYGB, except for a rapid increase during the first 30 min after meal ingestion. Glucagon-like peptide 1 (GLP-1) was substantially increased after RYGB, while gastric inhibitory polypeptide and glucagon decreased. Lower HbA1c was most strongly correlated with the percentage of weight loss for both groups. At baseline, a greater C-peptide index and 90-min postprandial C-peptide level were predictive of lower HbA1c at 1 year after RYGB. β-Cell glucose sensitivity, which improved only after RYGB, and improved disposition index were associated with lower HbA1c in both groups, independent of weight loss. Weight loss and preserved β-cell function both predominantly determine the greatest glycemic benefit after RYGB.

Indexed as

Gastric BypassWeight LossAdiponectinBlood GlucoseC-PeptideDiabetes Mellitus, Type 2FemaleGastric Inhibitory PolypeptideGlucagonGlucagon-Like Peptide 1Glucagon-Like Peptide 2Glycated HemoglobinHumansHypoglycemic AgentsInsulinInsulin ResistanceAdiponectinBlood GlucoseC-PeptideGastric Inhibitory PolypeptideGlucagonGlucagon-Like Peptide 1Glucagon-Like Peptide 2Glycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulin

Identifiers

PMID25901097
PMCPMC4542441

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.