Evidence map›Paper›PMID 23439632›Full record

Trial reportDiabetes care2013

Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: analysis of a randomized control trial comparing surgery with intensive medical treatment.

Sangeeta R Kashyap, Deepak L Bhatt, Kathy Wolski, Richard M Watanabe, Muhammad Abdul-Ghani, Beth Abood, Claire E Pothier, Stacy Brethauer, Steven Nissen, Manjula Gupta and 2 more

2 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 136 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
136citing papers in PubMed, 7 pooled it
38.6field-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.

NCT02532829 unknown statusnot on this mapstarted 2015, after this paper: background citation

Effects of Different Metabolic States and Surgical Models on Glucose Metabolism and Secretion of Ileal L-cell Peptides

TypeobservationalSponsorTurkish Metabolic Surgery FoundationRan2015 to 2016Enrolled240ConditionsObesity, Diabetes Mellitus, Type 2Armsblood sample analysis
NCT02610530 unknown statusnot on this mapstarted 2015, after this paper: background citation

Efficacy of Surgical Intervention for the Treatment of Diabetes Mellitus Type 2 in Overweight Non-responders in Comparison With Conventional Nonsurgical Medical Treatment

TypeobservationalSponsorTurkish Metabolic Surgery FoundationRan2015 to 2016Enrolled90ConditionsOverweight, Diabetes Mellitus, Type 2ArmsSleeve Gastrectomy with Ileal Transposition, Sleeve Gastrectomy with Transit Bipartition, Medical Treatment
3 · Its place in the literature

Who cites it

136 citing papers in PubMed, 7 syntheses or guidelines pooled it, 284 citations in OpenAlex.

  1. Pooled it
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  7. Surgery for weight loss in adults.The Cochrane database of systematic reviews · 2014
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  11. Lixisenatide Reduces Chylomicron Triacylglycerol by Increased Clearance.The Journal of clinical endocrinology and metabolism · 2019
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  20. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes.The New England journal of medicine · 2014 · on this map
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76 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

12 authors at 5 institutions in 1 country.

Sangeeta R KashyapEndocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio, USA. kashyas@ccf.org
Deepak L Bhatt
Kathy Wolski
Richard M Watanabe
Muhammad Abdul-Ghani
Beth Abood
Claire E Pothier
Stacy Brethauer
Steven Nissen
Manjula Gupta
John P Kirwan
Philip R Schauer
Cleveland Clinic · USBrigham and Women's Hospital · USCleveland Clinic Lerner College of Medicine · USThe University of Texas Health Science Center at San Antonio · USUniversity of Southern California · US

Funding

Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Effect of Bariatric Surgery on Mechanisms of Type 2 Diabetes: The B2D TrialR01DK089547 · NIDDK · CLEVELAND CLINIC LERNER COM-CWRU · PI KASHYAP, SANGEETA R, KIRWAN, JOHN P. · 2010 to 2013
$1.9M
NCATS NIH HHS UL1 TR000439NIDDK NIH HHS R01 DK089547NIDDK NIH HHS R01-DK089547
6 · The paper itself

Abstract

objectiveTo evaluate the effects of two bariatric procedures versus intensive medical therapy (IMT) on β-cell function and body composition. RESEARCH DESIGN AND

methodsThis was a prospective, randomized, controlled trial of 60 subjects with uncontrolled type 2 diabetes (HbA1c 9.7 ± 1%) and moderate obesity (BMI 36 ± 2 kg/m(2)) randomized to IMT alone, IMT plus Roux-en-Y gastric bypass, or IMT plus sleeve gastrectomy. Assessment of β-cell function (mixed-meal tolerance testing) and body composition was performed at baseline and 12 and 24 months.

resultsGlycemic control improved in all three groups at 24 months (N = 54), with a mean HbA1c of 6.7 ± 1.2% for gastric bypass, 7.1 ± 0.8% for sleeve gastrectomy, and 8.4 ± 2.3% for IMT (P < 0.05 for each surgical group versus IMT). Reduction in body fat was similar for both surgery groups, with greater absolute reduction in truncal fat in gastric bypass versus sleeve gastrectomy (-16 vs. -10%; P = 0.04). Insulin sensitivity increased significantly from baseline in gastric bypass (2.7-fold; P = 0.004) and did not change in sleeve gastrectomy or IMT. β-Cell function (oral disposition index) increased 5.8-fold in gastric bypass from baseline, was markedly greater than IMT (P = 0.001), and was not different between sleeve gastrectomy versus IMT (P = 0.30). At 24 months, β-cell function inversely correlated with truncal fat and prandial free fatty acid levels.

conclusionsBariatric surgery provides durable glycemic control compared with intensive medical therapy at 2 years. Despite similar weight loss as sleeve gastrectomy, gastric bypass uniquely restores pancreatic β-cell function and reduces truncal fat, thus reversing the core defects in diabetes.

Indexed as

Bariatric SurgeryBlood GlucoseDiabetes Mellitus, Type 2GastrectomyGastric BypassGlucagon-Like Peptide 1HumansInsulin ResistanceInsulin-Secreting CellsLipid MetabolismObesityWeight LossBlood GlucoseGlucagon-Like Peptide 1

Identifiers

PMID23439632
PMCPMC3714483
OpenAlexW1977819123

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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 OpenQuestion graph.