Obesity is considered the largest chronic non-communicable disease (globesity) worldwide with a growing trend in the near future. Weight loss programs are strongly recommended in obese patients, especially with type 1 diabetes mellitus (T2DM), although the majority of subjects do not reach or maintain the recommended weight loss target with nutritional intervention alone and one-third of those who achieve a significant weight loss returns to original body weight within one year. Metarecod® (Neopolicaptil Gel Retard) is a substance based medical device consisting of a macromolecule complex derived from high-fiber raw materials, whose mode of action consists in creating an endoluminal gel in the gut that limits glucose and lipids absorption. The primary aim of the present study is to assess whether the combination of Metarecod® and standard diet as compared to diet alone can achieve a superior weight loss over 12 months of treatment. The present study will also compare the effects of the combination of Metarecod® and diet vs diet alone on: 1. the improvement of glycemic variability and metabolic indexes; 2. the oxidative status, the endothelial anti-thrombotic activity, the inflammatory status; 3. the induction of favorable changes in gut microbiota composition and intestinal permeability.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
180
Policaptil Gel Retard: Metarecod®. The medical device will be given as 1 sachet twice daily
Diet program will be planned to achieve a ≥8% body weight relative reduction over 12 months and tailored calculating a 20% caloric relative decrease from habitual energy intake, corresponding to an average energy deficit of approximately 500 kcal/daily (approximately a total of 1,200-1,500/daily Kcal for women and 1,500-1,800/daily Kcal for men), with \<30% of total calories from fat (\<10% from satured fats) and at least 15% of total calories from proteins. For carbohydrate intake, low glycemic index food will be preferred to high glycemic index food, to prevent higher post prandial glycemic excursions
Fondazione Policlinico Universitario A. Gemelli IRCCS; UOC Diabetologia
Rome, Lazio, Italy
Body Weight
Difference in body weight expressed in kg after 12 months between randomized arms
Time frame: 12 months
Glycemic variability
Glycemic variability, as assessed by continuous glucose monitoring (CGM)
Time frame: 12 months
8-iso-Prostaglandin (PG) F2α
Change on the oxidative status in vivo, as assessed by the measurement of the urinary excretion of the F2-isoprostane
Time frame: 12 months
2,3-dinor-6-keto-PGF1α
Change of the endothelial anti-thrombotic activity in vivo as assessed by the production of the vasodilator and platelet inhibitor prostanoid, prostacyclin (PGI2), major urinary enzymatic metabolite 2,3-dinor-6-keto-PGF1α
Time frame: 12 months
Interleukin (IL)-6
Change on inflammatory status assessed through the change of serum levels of interleukin (IL-6)
Time frame: 12 months
C-reactive protein
Change on inflammatory status assessed through the change of serum levels of C-reactive protein (CRP)
Time frame: 12 months
Waist circumference
Change in waist circumference after 12 months between arms
Time frame: 12 months
Achieving the target weight loss
Percentage of subjects who will reach the target percentage weight loss of 8%
Time frame: 12 months
Gut microbiota composition
Gut microbiota composition, assessed by 16S RNA sequencing
Time frame: 12 months
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