Evidence map›Paper›PMID 33158945›Full record

Trial reportDiabetes care2021

The Effect of Standard Versus Longer Intestinal Bypass on GLP-1 Regulation and Glucose Metabolism in Patients With Type 2 Diabetes Undergoing Roux-en-Y Gastric Bypass: The Long-Limb Study.

Alexander Dimitri Miras, Anna Kamocka, Belén Pérez-Pevida, Sanjay Purkayastha, Krishna Moorthy, Ameet Patel, Harvinder Chahal, Gary Frost, Paul Bassett, Lidia Castagnetto-Gissey and 7 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT05446415. Cited by 23 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 4 pooled it
2.7field-weighted citation impact, top 9% 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.

NCT05446415 naunknown status

Evaluation of L-Cell Activity in the Small Intestine as Biliopancreatic Loop Extension in Obese Patients With DM2 Submitted to Roux-en-Y Gastric Bypass

Ran2020Enrolled20Registered outcomes2Posted comparisons0ConditionsSevere Obesity, Type 2 Diabetes Mellitus in ObeseArmsAnalyze basal expression incretin for immunolabeling and mRNA expression glucagon-like secretion peptide-1 (GLP-1) and peptide YY (PYY 3-36) incretins by L cells.
PMID 28956082PMID 26048514PMID 35730880other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.

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  13. Surgical Strategies for the Management of Obesity.Methodist DeBakey cardiovascular journal · 2025
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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

17 authors at 4 institutions in 2 countries.

Alexander Dimitri MirasDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.ORCID 0000-0003-3830-3173
Anna KamockaDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.
Belén Pérez-PevidaDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.
Sanjay PurkayasthaDepartment of Surgery and Cancer, Imperial College London, London, U.K.
Krishna MoorthyDepartment of Surgery and Cancer, Imperial College London, London, U.K.
Ameet PatelDepartment of Surgery, King's College London, London, U.K.
Harvinder ChahalDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.
Gary FrostDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.ORCID 0000-0003-0529-6325
Paul BassettStatsConsultancy Ltd., London, U.K.
Lidia Castagnetto-GisseyDepartment of Surgery, King's College London, London, U.K.
Lucy CoppinFaculty of Health and Medical Sciences, University of Surrey, Guildford, U.K.
Nicola JacksonFaculty of Health and Medical Sciences, University of Surrey, Guildford, U.K.
Anne Margot UmplebyFaculty of Health and Medical Sciences, University of Surrey, Guildford, U.K.
Stephen Robert BloomDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.
Tricia TanDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.ORCID 0000-0001-5873-3432
Ahmed Rashid AhmedDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, U.K.
Francesco RubinoDepartment of Surgery, King's College London, London, U.K. francesco.rubino@kcl.ac.uk.ORCID 0000-0001-8581-2515
Imperial College London · GBKing's College London · GBUniversity of Surrey · GBStatistical Research (United States) · US

Funding

Department of Health 13/121/07Department of Health NIHR130639Medical Research Council MR/K02115X/1
6 · The paper itself

Abstract

objectiveRoux-en-Y gastric bypass (RYGB) characteristically enhances postprandial levels of glucagon-like peptide 1 (GLP-1), a mechanism that contributes to its profound glucose-lowering effects. This enhancement is thought to be triggered by bypass of food to the distal small intestine with higher densities of neuroendocrine L-cells. We hypothesized that if this is the predominant mechanism behind the enhanced secretion of GLP-1, a longer intestinal bypass would potentiate the postprandial peak in GLP-1, translating into higher insulin secretion and, thus, additional improvements in glucose tolerance. To investigate this, we conducted a mechanistic study comparing two variants of RYGB that differ in the length of intestinal bypass. RESEARCH DESIGN AND

methodsA total of 53 patients with type 2 diabetes (T2D) and obesity were randomized to either standard limb RYGB (50-cm biliopancreatic limb) or long limb RYGB (150-cm biliopancreatic limb). They underwent measurements of GLP-1 and insulin secretion following a mixed meal and insulin sensitivity using euglycemic hyperinsulinemic clamps at baseline and 2 weeks and at 20% weight loss after surgery.

resultsBoth groups exhibited enhancement in postprandial GLP-1 secretion and improvements in glycemia compared with baseline. There were no significant differences in postprandial peak concentrations of GLP-1, time to peak, insulin secretion, and insulin sensitivity.

conclusionsThe findings of this study demonstrate that lengthening of the intestinal bypass in RYGB does not affect GLP-1 secretion. Thus, the characteristic enhancement of GLP-1 response after RYGB might not depend on delivery of nutrients to more distal intestinal segments.

Indexed as

Diabetes Mellitus, Type 2Gastric BypassBlood GlucoseGlucagon-Like Peptide 1HumansInsulinJejunoileal BypassBlood GlucoseGlucagon-Like Peptide 1Insulin

Identifiers

PMID33158945
PMCPMC8132320
OpenAlexW3095076757

What OpenQuestion holds

Textmetadata
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.