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Glucagon-like Peptide 1, Glucose Metabolism and Gastric Bypass

Early Phase 1
Recruiting
Conditions
Post-bariatric Surgery
Interventions
Drug: exendin -(9-39)
Drug: exendin-(9-39)
Registration Number
NCT01803451
Lead Sponsor
The University of Texas Health Science Center at San Antonio
Brief Summary

The overall goal of this project is to understand the mechanisms by which gastric bypass surgery improves glucose metabolism.

The central hypothesis guiding this project is that the reconfiguration of intestinal transit with the Roux-en-Y will increase the release of insulinotropic GI hormones, termed incretins that improve insulin secretion and glucose metabolism. The study is divided into three specific aims.

1. To determine the role of incretin hormones on insulin secretion in patients with gastric bypass surgery using intravenous-oral hyperglycemic clamp.

2. To compare incretin effect and glucose tolerance among patient who suffer from hypoglycemia after RYGB and asymptomatic surgical and non-surgical individuals.

3. To quantify the contribution of GLP-1 to incretin effect enhancement following surgery.

Detailed Description

The overall goal of this project is to understand the mechanisms by which gastric bypass surgery improves glucose metabolism.

The central hypothesis guiding this project is that the reconfiguration of intestinal transit with the Roux-en-Y will increase the release of insulinotropic GI hormones, termed incretins that improve insulin secretion and glucose metabolism. The study is divided into three specific aims.

1. To determine the role of incretin hormones on insulin secretion in patients with gastric bypass surgery using intravenous-oral hyperglycemic clamp.

2. To compare incretin effect and glucose tolerance among patient who suffer from hypoglycemia after RYGB and asymptomatic surgical and non-surgical individuals.

3. To quantify the contribution of GLP-1 to incretin effect enhancement following surgery.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • age 18-65
  • healthy control without diabetes or active organ disease
  • Individuals with bariatric surgery
  • recurrent hypoglycemia post gastric bypass
Exclusion Criteria
  • pregnancy
  • significant anemia
  • diabetes currently unless pre-op for bariatric surgery procedure
  • GI obstruction

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Labeled meal tolerance testexendin -(9-39)The effect of GLP-1 receptor blockade on glucose tolerance and glucose kinetics are evaluated in the group patients with bariatric surgery vs. nonsurgical using exendin-9-39 infusion during one of the the 2-day dual tracer studies of meal tolerance test
hyperglycemic clamp-Meal tolerance testexendin-(9-39)these studies are to evaluate the effect of exendin-9 on insulin secretion before and after meal ingestion in patients after bariatric surgeries compared to non-surgical controls
Primary Outcome Measures
NameTimeMethod
The investigator measure glucose, islet and GI hormonal levels in response to meal ingestion as a composite measure and the percentage of contribution of GLP-1 contribution to postprandial insulin levels will also be calculatedup to 1 year (10 sessions)
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

Texas Diabetes Institute - University Health System

🇺🇸

San Antonio, Texas, United States

South Texas Veterans Health Care System

🇺🇸

San Antonio, Texas, United States

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