Condition: Bariatric Surgery · Type 2 Diabetes · Sponsor: Assistance Publique - Hôpitaux de Paris
Obesity progresses worldwide with few effective treatments leading to a burst in Bariatric surgery (BS). France is the 3rd country in BS numbers yearly. BS improves diabetes (T2D) and even induces diabetes remission (DR) in 60% of patients. Thus, an expert consensus recommended extending BS to T2D with BMI≥30kg/m² with uncontrolled glycaemia, anticipating even more BS. Glycaemic control further deteriorates in the longer term in non DR (NDR) patients and relapse occurs in some DR patients, urging the need to add new therapy to control glycaemia and provide new recommendations in the future. Obesity and T2D are characterized by gut microbiota dysbiosis with low to very low microbial gene richness (MGR). About 75% of patients' candidates for BS are in the low MGR category. Whereas BS modifies microbiota composition and increases MGR 1-year post-BS, we demonstrated that only a few patients reach high MGR. Dysbiosis can be improved by several means; fibre enriched diet, prebiotics, probiotics also improve metabolic alterations and insulin resistance in mice. However, human studies observed rather divergent results: some studies display a beneficial effect in improving insulin-resistance but to a small extent while others do not display any significant effects at all. Therefore, other innovative strategies should be tested in humans. For example, Faecal microbiota transfer (FMT) ameliorates insulin sensitivity and MGR in metabolic syndrome patients, but was never tested in T2D n…
This description comes directly from the study's public registry record.
Judith Aron-Wisnewsky, Pr · +33 1 42 17 75 41 · judith.aron-wisnewsky@aphp.fr
Karine Clement, Pr · +33 1 42 17 79 28 · karine.clement@aphp.fr
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| Groupe hospitalier Pitié-Salpêtrière | Paris, France | Recruiting |
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Source record: clinicaltrials.gov/study/NCT06192693