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.
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.
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.
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.
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
Open the trial in the graphWho cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Efficacy and Safety of Anti-Obesity Medications for Weight Loss Maintenance in Adults With Overweight or Obesity: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.Diabetes, obesity & metabolism · 2026Pooled it
- The Role of Total Small Bowel Length and its Measurement in Metabolic Bariatric Surgery. A Systematic Review.Obesity surgery · 2026Pooled it
- Pooled it
- Length of biliopancreatic limb in Roux-en-Y gastric bypass and its impact on post-operative outcomes in metabolic and obesity surgery-systematic review and meta-analysis.International journal of obesity (2005) · 2022Pooled it
- Long-term Outcome of the Dutch Common Channel Trial (DUCATI): Preservation of Superior Weight Loss Results Without Significant Malnutrition Side Effects.Obesity surgery · 2024Trial
- Laparoscopic Roux-Y-gastric bypass versus laparoscopic one-anastomosis gastric bypass for obesity: clinical & metabolic results of a prospective randomized controlled trial.Surgical endoscopy · 2024Trial
- Hybrid Laparoscopic-Endoscopic Partial Jejunal Diversion with Magnetic Anastomosis in Obesity and Type 2 Diabetes: Durable 3-Year Metabolic Results.Endoscopy international open · 2026Article
- Gut microbiota alterations induced by Roux-en-Y gastric bypass result in glucose-lowering by enhancing intestinal glucose excretion.Gut microbes · 2025Article
- Novel insights on remnant stomach following Roux-en-Y gastric bypass surgery based on histological evaluation and quantitative proteomics analysis.Scientific reports · 2025Article
- Short- and Long-Term Impact of Metabolic Surgery on Obesity Outcomes in Iranian Non-Diabetic Obese Patients.Maedica · 2025Article
- Enhanced Total Weight Loss 2 Years Post-Roux-en-Y Gastric Bypass with Longer Biliopancreatic Limb.Obesity surgery · 2025Article
- Editorial: Effects and mechanisms of bariatric surgery in relieving obesity and its complications.Frontiers in endocrinology · 2025Article
- Surgical Strategies for the Management of Obesity.Methodist DeBakey cardiovascular journal · 2025Review
- Evaluation of l-cell activity in the small intestine according to the extension of the biliopancreatic loop in patients undergoing Roux-en-Y gastric by-pass.Clinics (Sao Paulo, Brazil) · 2025Article
- Research progress in precision medicine for type 2 diabetes based on the GLP-1.Frontiers in endocrinology · 2025Review
- Comparative Effect of Insulin Resistance Reduction and Hormonal Alterations on Type 2 Diabetes Remission After Bariatric Surgery.Journal of clinical medicine · 2024Article
- Bariatric surgery improves postprandial VLDL kinetics and restores insulin-mediated regulation of hepatic VLDL production.JCI insight · 2023Article
- [Current evidence on loop length in intestinal bypass procedures].Chirurgie (Heidelberg, Germany) · 2023Review
- Upper gut heat shock proteins HSP70 and GRP78 promote insulin resistance, hyperglycemia, and non-alcoholic steatohepatitis.Nature communications · 2022Article
- The impact of bariatric surgery procedures on the modulation of cardiometabolic risk factors in patients with severe obesity: a 12-month follow-up.The Journal of international medical research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 4 institutions in 2 countries.
Funding
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.
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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.