The goal of this randomized clinical trial is to evaluate glycemic control in patients with morbid obesity and type 2 diabetes after Roux-en-Y gastric bypass (RYGBP) and RYGBP with fundus resection. The main questions to answer are: * Rate of diabetes remission and the role of the gastrointestinal hormones * Whether fundus resection leads to improved glycemic control Patients will randomly undergo typical RYGBP or RYGBP with fundus resection. Gastrointestinal hormones profile \[ghrelin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), glucagon\], glucose levels and insulin response will be measured preoperatively, at 6 months and at 12 months, during 120-min OGTT.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
24
Laparoscopic RYGBP included the creation of a small gastric pouch, with a 200cm biliopancreatic limb and a 150cm alimentary limb.
Laparoscopic RYGBP included the creation of a small gastric pouch, with a 200cm biliopancreatic limb and a 150cm alimentary limb. Fundus resection is further applied in this arm.
University of Patras, University Hospital of Patras
Pátrai, Rio, Greece
Diabetes remission in both groups
Change in HbA1c levels
Time frame: At 6 months and 12 months postoperatively
Change in fasting and postprandial glucose levels
Glucose levels (mg/dl)
Time frame: At 6 months and 12 months postoperatively
Change in insulin levels, fasting and postprandial
Insulin levels (μIU/ml)
Time frame: At 6 months and 12 months postoperatively
Change in HOMA - IR
HOMA IR calculation with glucose (mg/dl) and insulin (mU/L)
Time frame: At 6 months and 12 months postoperatively
Change in ghrelin levels
Fasting and postprandial ghrelin levels (pg/ml)
Time frame: At 6 months and 12 months postoperatively
Change in GLP-1 levels
Fasting and postprandial GLP-1 levels (pg/ml)
Time frame: At 6 months and 12 months postoperatively
Change in PYY levels
Fasting and postprandial PYY levels (ng/ml)
Time frame: At 6 months and 12 months postoperatively
Change in glucagon levels
Fasting and postprandial glucagon levels (pg/ml)
Time frame: At 6 months and 12 months postoperatively
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