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Trial registered on ANZCTR
Registration number
ACTRN12609000286246
Ethics application status
Approved
Date submitted
15/09/2008
Date registered
18/05/2009
Date last updated
16/11/2018
Date data sharing statement initially provided
16/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Weight Loss and Type 2 Diabetes: A prospective randomised controlled trial intervention study of best practice medical management versus the additional placement of the Lap-Band System in overweight patients
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Scientific title
Weight Loss and Type 2 Diabetes: A prospective randomised controlled trial intervention study of best practice medical management versus the additional placement of the Lap-Band System in overweight patients
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Secondary ID [1]
718
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Nil
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Universal Trial Number (UTN)
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Trial acronym
Nil
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Obesity
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Diabetes Type 2
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Condition category
Condition code
Metabolic and Endocrine
3858
3858
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0
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Diabetes
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Diet and Nutrition
4932
4932
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0
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Obesity
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Placement of the Lap-Band (Laparoscopic Adjustable Gastric Band) by surgery in overweight individuals in the Body Mass Index 25-30 range. This procedure is permanent and patients will be followed for two years after surgery.
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Intervention code [1]
3406
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Treatment: Surgery
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Comparator / control treatment
Best practice medical management (optimal standard therapy) is a program of optimal medical treatment. Advice from a diabetes educator and dietician regarding diet, weight loss, movement and exercise, and any behavioral changes will take place 3-monthly. A specialist endocrinologist will manage any medication necessary to control blood sugar levels, high blood pressure and other diabetes related conditions 3-monthly. This advice and education will take the form of one hour sessions 3-monthly for a total of 2 years. Patients with HbA1c>7% at 9 months will be reviewed 6-weekly until 12 months
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Control group
Active
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Outcomes
Primary outcome [1]
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Biochemical assessment of glycaemic control of type 2 diabetes (HbA1c, fasting glucose)
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Assessment method [1]
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Timepoint [1]
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3,6,9,12,24, and 60
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Primary outcome [2]
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Assessment of co-morbidity control including abnormalities of blood pressure, serum lipids and liver function (via measurement of liver enzymes concentrations)
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Assessment method [2]
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Timepoint [2]
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3, 6, 9, 12, 24, and 60
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Primary outcome [3]
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Resolution of diabetes (fasting and 2h glucose following 75g oral glucose <7.1 and <11.1 respectively)
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Assessment method [3]
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Timepoint [3]
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months 24 and 60
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Secondary outcome [1]
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Clinical measures related to metabolic syndrome (eg lipids, waist circumference, medication burden, BP)
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Assessment method [1]
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Timepoint [1]
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months 3, 6, 9, 12 and 60
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Secondary outcome [2]
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Cost effectiveness - via technical efficiency analysis, which will draw on both the primary data collections from the trial (costs of the intervention; change in weight; cases of diabetes resolved; change in functional status), as well as economic modelling.
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Assessment method [2]
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Timepoint [2]
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12 and 60 months
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Secondary outcome [3]
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Weight loss will be measured by Excess weight lost in kilograms (EWL) or Body Mass Index (BMI) points lost
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Assessment method [3]
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Timepoint [3]
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months 3, 6, 9, 12 and 60
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Secondary outcome [4]
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insulin and C-peptide response to 25g IV glucose
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Assessment method [4]
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Timepoint [4]
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Months 12 and 60
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Eligibility
Key inclusion criteria
1. Be between 18 and 65 years of age, 2. Have a body mass index greater than 25 and less than 30 kg/m2. 3. Have been diagnosed with type 2 diabetes in the last 5 years. 4. Be able to understand the options and study requirements and to comply with the requirements of each program. 5. Willing to be randomized.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. If there was lack of acceptance of the randomization process,
2. If there were a history of previous abdominal surgery which would potentially preclude laparoscopic placement of the band.
3. If there was a history of previous obesity surgery
4. If there were any contraindication to LapBand (LAGB) placement.
5. If there were medical issues which contra-indicated the application of either arm of the study. These would include; acute myocardial infarction within the past 6 months, dementia, active psychosis, concurrent experimental drug use, pregnancy or intending to conceive in the next two years, lactation, illicit drug use, excessive alcohol intake, use of drugs known to affect body composition, cytotoxic drugs, internal malignancy, or major organ failure.
6. Systemic lupus erythematosis or other auto-immune disease.
7. Direct hypothalamic damage as a cause of obesity.
8. If they were unable to understand the risks, realistic benefits and compliance requirements of the Lap-Band intervention and conventional management of diabetes.
9. The patient had type 1 diabetes or diabetes was secondary to specific diseases such as haemachromatosis or chronic pancreatitis.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Initial recruitment into the study would be achieved by a general awareness campaign, which emphasized a study of weight loss on type 2 diabetes in the overweight patient. Interested candidates would be provided with detailed information regarding the problems of diabetes and excess weight on at least two occasions along with detailed information of the two treatment arms of the study.
The eligible patients will be randomly assigned to receive:
(1) a continuing program of medical treatment which will have a conventional program of advice and education regarding eating and exercise and include conventional medical therapy for diabetes and associated conditions (Program 1) or:
(2) the LAGB procedure as an additional intervention (Program 2).
Allocation was achieved via the use of sealed opaque envelopes with the letters A and B enclosed, which corresponded to either the treatment group or control group. This procedure was carried out by a data manager not involved with the study (in any other way)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The random assignment will be computer generated
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2009
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Actual
9/11/2009
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Date of last participant enrolment
Anticipated
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Actual
16/06/2011
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Date of last data collection
Anticipated
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Actual
15/08/2016
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Sample size
Target
38
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Accrual to date
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Final
51
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Monash University
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Address [1]
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Wellington Rd
Victoria 3800
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Wellington Rd
Victoria 3800
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Country
Australia
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Secondary sponsor category [1]
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Other
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Name [1]
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Centre for Obesity Research and Education
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Address [1]
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Monash University Medical School
The Alfred Hospital
Commercial Rd
Melbourne, 3004
Victoria
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Country [1]
3479
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Avenue Hospital
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Ethics committee address [1]
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40 The Avenue Windsor VIC 3181
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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02/12/2008
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Approval date [1]
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12/01/2009
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Ethics approval number [1]
301951
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0101
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Summary
Brief summary
The primary aim of this proposal is to compare LAGB surgery with optimal medical therapy over the period of the 2-year trial. The hypothesis is LAGB provides better results.
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Trial website
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Trial related presentations / publications
Wentworth JM (2014) Multidisciplinary diabetes care with and without bariatric surgery in overweight people: a randomised controlled trial. Lancet Diabetes Endocrinol. 2014 Jul;2(7):545-522014. PMID: 24731535
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Public notes
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Contacts
Principal investigator
Name
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Prof Paul O'Brien
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Address
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Centre for Obesity Research and Education
Monash University
Level 6 The Alfred Centre
99 Commercial Rd
Melbourne Vic 3004
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Country
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Australia
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Phone
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+61422992891
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Miss Kristine Egberts
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Address
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Centre for Obesity Research and Education (CORE)
School of Public Health & Preventive Medicine
Monash University
The Alfred Hospital, Commercial Road
Melbourne Victoria 3004
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Country
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Australia
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Phone
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+61 2 9903 0686
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Miss Kristine Egberts
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Address
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Centre for Obesity Research and Education (CORE)
School of Public Health & Preventive Medicine
Monash University
The Alfred Hospital, Commercial Road
Melbourne Victoria 3004
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Country
3019
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Australia
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Phone
3019
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+61 2 9903 0686
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Fax
3019
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Email
3019
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Five-Year Outcomes of a Randomized Trial of Gastric Band Surgery in Overweight but Not Obese People With Type 2 Diabetes
2017
https://doi.org/10.2337/dc16-2149
N.B. These documents automatically identified may not have been verified by the study sponsor.
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