Imperial College London
Alternate

Professor Sir Steve Bloom FMedSci, FRS

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Departmental Academic REF2014 Lead
 
 
 
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Contact

 

+44 (0)20 7594 9048s.bloom Website

 
 
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Assistant

 

Ms Keda Price-Cousins +44 (0)20 7594 9048

 
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Location

 

6N3Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Miras:2021:10.3310/eme08030,
author = {Miras, AD and Kamocka, A and Tan, T and Pérez-Pevida, B and Chahal, H and Moorthy, K and Purkayastha, S and Patel, A and Umpleby, AM and Frost, G and Bloom, SR and Ahmed, AR and Rubino, F},
doi = {10.3310/eme08030},
journal = {Efficacy and Mechanism Evaluation},
title = {Long limb compared with standard limb Roux-en-Y gastric bypass for type 2 diabetes and obesity: the LONG LIMB RCT},
url = {http://dx.doi.org/10.3310/eme08030},
volume = {8},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundRoux-en-Y gastric bypass is recognised as a standard of care in the treatment of diabetes mellitus and obesity. However, the optimal length of the Roux-en-Y gastric bypass limbs remains controversial, with substantial variation in practice. Specifically, a longer biliopancreatic limb length of 150 cm (‘long limb’) has been hypothesised to be better for the treatment of diabetes mellitus because it increases the postprandial secretion of gut hormones, such as glucagon-like peptide 1, and increases insulin sensitivity, compared with the Roux-en-Y gastric bypass utilising a standard biliopancreatic limb length of 50 cm (‘standard limb’).ObjectiveTo evaluate the mechanisms, clinical efficacy and safety of long limb versus the standard limb Roux-en-Y gastric bypass in patients undergoing metabolic surgery for obesity and diabetes mellitus.DesignA double-blind, mechanistic randomised controlled trial was conducted to evaluate the mechanisms, clinical efficacy and safety of the two interventions.SettingImperial College London, King’s College London and their associated NHS trusts.ParticipantsPatients with obesity and type 2 diabetes mellitus who were eligible for metabolic surgery.InterventionsParticipants were randomly assigned (1 : 1) to 150-cm (long limb) or 50-cm (standard limb) biliopancreatic limb Roux-en-Y gastric bypass with a fixed alimentary limb of 100 cm. The participants underwent meal tolerance tests to measure glucose excursions, glucagon-like peptide 1 and insulin secretion, and hyperinsulinaemic–euglycaemic clamps with stable isotopes to measure insulin sensitivity preoperatively, at 2 weeks after the surgery and at matched 20% total body weight loss. Clinical follow-up continued up to 1 year.Main outcome measuresPrimary – postprandial peak of active glucagon-like peptide 1 concentration at 2 weeks after intervention. Secondary – fasting and postprandial glucose an
AU  - Miras,AD
AU  - Kamocka,A
AU  - Tan,T
AU  - Pérez-Pevida,B
AU  - Chahal,H
AU  - Moorthy,K
AU  - Purkayastha,S
AU  - Patel,A
AU  - Umpleby,AM
AU  - Frost,G
AU  - Bloom,SR
AU  - Ahmed,AR
AU  - Rubino,F
DO  - 10.3310/eme08030
PY  - 2021///
SN  - 2050-4365
TI  - Long limb compared with standard limb Roux-en-Y gastric bypass for type 2 diabetes and obesity: the LONG LIMB RCT
T2  - Efficacy and Mechanism Evaluation
UR  - http://dx.doi.org/10.3310/eme08030
UR  - https://www.journalslibrary.nihr.ac.uk/eme/eme08030#/abstract
UR  - http://hdl.handle.net/10044/1/89174
VL  - 8
ER  -
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