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The Impact of Different Carbohydrate Restriction After a Gastric Bypass on the Ketosis and Ketoacidosis

Not Applicable
Recruiting
Conditions
Obesity, Morbid
NASH
Ketosis
Keto Acidosis
Carbohydrate Metabolism Disorder
Interventions
Other: Carbohydrate Restriction after a Gastric Bypass
Registration Number
NCT06338969
Lead Sponsor
The Society of Bariatric and Metabolic Surgeons of Kazakhstan
Brief Summary

Background:

Ketosis after bariatric surgery is a metabolic process that occurs when the body breaks down fat for energy because of not getting enough carbohydrates.

Insufficient production of ketone bodies reduces the rate of weight loss, and excessive amounts of ketones can lead to ketoacidosis or liver failure in patients with nonalcoholic steatohepatitis (NASH).

The investigators hypothesize that weight loss is directly related to calorie intake, and a significant reduction in carbohydrate content leads to increased ketosis and the risk of ketoacidosis.

Objectives:

The study aimed to compare the incidence of ketoacidosis and liver failure in patients with NASH with different intakes of carbohydrates in the early postoperative period after gastric bypass. In addition, the investigators want to find out how carbohydrate restriction will affect weight loss for up to 1 year.

Detailed Description

Methods:

This study is a three-arm randomized controlled trial. All patients will undergo laparoscopic one anastomotic gastric bypass. In the postoperative period, all patients will receive normal daily amounts of protein and fat. Depending on the amount of carbohydrates that will be received after surgery, patients will randomly (no mask) be divided into three groups:

The first group: 51-75% deficit in carbohydrates Second group: 26-50% deficit in carbohydrates The third group: has a 1-25% deficit in carbohydrates.

Primary outcome measurement Compare the incidence of ketoacidosis and liver failure in three groups of patients with NASH with different intakes of carbohydrates in the early postoperative period after gastric bypass.

Secondary outcome measurements Change in body mass index (Δ BMI). Effect weight loss for up to 1 year.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
150
Inclusion Criteria
  • obesity patients BMI 30-50 kg/m2.
  • patients with nonalcoholic steatohepatitis (NASH).
Exclusion Criteria
  • patients with active physical sports
  • diabetes
  • cirrhosis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Carbohydrate Restriction after a Gastric Bypass: 26-50% deficit in carbohydratesCarbohydrate Restriction after a Gastric BypassIn the postoperative period, the amount of carbohydrate intake was reduced by counting carbohydrates in a glucose solution in the first three days after surgery and counting carbohydrates in food. Created a carbohydrate deficit: 26-50% deficit in carbohydrates.
Carbohydrate Restriction after a Gastric Bypass:1-25% deficit in carbohydratesCarbohydrate Restriction after a Gastric BypassIn the postoperative period, the amount of carbohydrate intake was reduced by counting carbohydrates in a glucose solution in the first three days after surgery and counting carbohydrates in food. Created a carbohydrate deficit:1-25% deficit in carbohydrates.
Carbohydrate Restriction after a Gastric Bypass: 51-75% deficit in carbohydratesCarbohydrate Restriction after a Gastric BypassIn the postoperative period, the amount of carbohydrate intake was reduced by counting carbohydrates in a glucose solution in the first three days after surgery and counting carbohydrates in food. Created a carbohydrate deficit of 51-75%.
Primary Outcome Measures
NameTimeMethod
Cases of ketosis and incidence of ketoacidosisThe time frame is baseline, first 7 days, 1, 3, 6,12 months after surgery.

Compare the incidence of ketoacidosis and liver failure in three groups of patients with NASH with different intakes of carbohydrates in the early postoperative period after gastric bypass

Cases of liver failureThe time frame is baseline, first 7 days, 1, 3, 6,12 months after surgery.

Compare the incidence of liver failure in three groups of patients with NASH with different intakes of carbohydrates in the early postoperative period after gastric bypass

Secondary Outcome Measures
NameTimeMethod
Change in body mass index (Δ BMI)The time frame is baseline,1, 3, 6,12 months after surgery.

This measurement assesses the change in BMI after the intervention. Weight (kg) and height (cm) will be combined in the BMI (kg/m2).

Trial Locations

Locations (1)

Oral Ospanov

🇰🇿

Astana, Aqmola, Kazakhstan

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