Evidence map›Paper›PMID 30315341›Full record

Trial reportDiabetologia2019

Postprandial hypoglycaemia after Roux-en-Y gastric bypass in individuals with type 2 diabetes.

Daniela Guarino, Diego Moriconi, Andrea Mari, Eleni Rebelos, Daria Colligiani, Simona Baldi, Marco Anselmino, Ele Ferrannini, Monica Nannipieri

Registry-linked trialAbstract readClinical Trial
PubMed Publisher
In one paragraph

Trial report in Diabetologia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06132477 (Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric), which is not on this map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
2.4field-weighted citation impact, top 12% 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.

NCT06132477 phase4recruitingstarted 2024, after this paper: background citation

Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric

Ran2024Enrolled150Registered outcomes5Posted comparisons0ConditionsDiabetes Mellitus, Hypertension, Metabolic Syndrome, Morbid ObesityArmsGLP-1 receptor agonist
PMID 28266779PMID 36765019PMID 32656729PMID 21844879PMID 28938270PMID 22673227PMID 24679060PMID 25412152PMID 25595383PMID 26511102PMID 27038046PMID 27219496other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Review
  5. Review
  6. Article
  7. Review
  8. Review
  9. Bariatric surgery to treat hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2023
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
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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

9 authors at 4 institutions in 1 country.

Daniela GuarinoDepartment of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
Diego MoriconiDepartment of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
Andrea MariCNR Institute of Neurosciences, Padua, Italy.
Eleni RebelosDepartment of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
Daria ColligianiDepartment of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
Simona BaldiDepartment of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy.
Marco AnselminoBariatric Surgery Unit, Santa Chiara Hospital, Pisa, Italy.
Ele FerranniniCNR Institute of Clinical Physiology, Pisa, Italy.
Monica NannipieriDepartment of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, 56126, Pisa, Italy. monica.nannipieri@dmi.unipi.it.ORCID 0000-0003-1346-2813
University of Pisa · ITIstituto di Fisiologia Clinica · ITNeuroscience Institute · ITOspedale Santa Chiara · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisPostprandial hypoglycaemia (PPHG) is a complication of Roux-en-Y gastric bypass (RYGB) surgery in normoglycaemic individuals. In type 2 diabetes, RYGB improves glucose metabolism, but whether this improvement is related to the later development of PPHG is not known. We investigated the presence and mechanisms of PPHG in individuals with type 2 diabetes undergoing RYGB.

methodsA total of 35 obese individuals with type 2 diabetes underwent an OGTT before and 24 months after surgery. PPHG was defined as a plasma glucose level of ≤3.3 mmol/l when not taking glucose-lowering agents. Insulin sensitivity was assessed by oral glucose insulin sensitivity index and beta-cell function by mathematical modelling of the plasma glucose, insulin and C-peptide concentrations.

resultsAfter surgery, PPHG occurred in 11 of 35 individuals who underwent RYGB. Before surgery, BMI was lower, glycaemic control less good and time of glucose peak earlier in the PPHG vs No PPHG group, and the duration of diabetes was shorter with PPHG (all p ≤ 0.05). In addition, insulin sensitivity was greater in the PPHG than No PPHG group (p = 0.03). After surgery, BMI and fasting glucose and insulin levels decreased similarly in the two groups; insulin secretion during the first hour of the OGTT increased more in the PPHG than No PPHG group (p = 0.04). Beta-cell glucose sensitivity increased more in individuals with PPHG than those without (p = 0.002). Over the same time interval, the glucagon-like peptide 1 (GLP-1) response was lower in individuals with PPHG before surgery (p = 0.05), and increased more after surgery. At 2 h after glucose ingestion in the OGTT, postsurgery plasma glucagon level was significantly lower in the PPHG than No PPHG group. CONCLUSIONS/

interpretationIn morbidly obese individuals with type 2 diabetes, spontaneous PPHG may occur after bariatric surgery independently of a remission of diabetes. Before surgery, individuals had a shorter duration and were more insulin sensitive. Two years after surgery, these individuals developed greater beta-cell glucose sensitivity, and showed greater insulin and GLP-1 release early in the OGTT.

Indexed as

Gastric BypassC-PeptideDiabetes Mellitus, Type 2FemaleGlucose Tolerance TestHumansHypoglycemiaMaleObesity, MorbidC-PeptideBeta-cell glucose sensitivityGLP-1GlucagonInsulin sensitivityReactive hypoglycaemiaRoux-en-Y gastric bypassType 2 diabetes mellitus

Identifiers

PMID30315341
OpenAlexW2896050782

What OpenQuestion holds

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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.