Impact of Per Oral Pyloromyotomy (POP) on Glycemic Control in Diabetes
Impact of Endoscopic Per-Oral Pyloromyotomy (POP) on Glycemic Control in Gastroparesis Patients With Poorly Controlled Diabetes Mellitus
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Deanne Nash, RN
- Phone Number: 216-445-0953
- Email: nashd@ccf.org
Study Locations
-
-
Ohio
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Cleveland, Ohio, United States, 44195
- Recruiting
- Cleveland Clinic Foundation
-
Contact:
- Mathew Allemang, MD
- Phone Number: 216 491-7861
- Email: ALLEMAM@ccf.org
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients 18 years of age and older
- Patients with gastroparesis with an average HbA1c> 7.5% over the past 3 months
- Patient that have a diagnosis of gastroparesis established by documented delayed gastric emptying by either a wireless motility capsule study or a nuclear gastric emptying study, with no evidence of gastric obstruction.
- Patients are able to complete all study requirements
Exclusion Criteria:
- Patients <18 years of age
- Patients with gastroparesis with an average HbA1c< 7.5% over the past 3 months
- Patients unable or refuse to complete the study requirements
- Patients who are unable or refuse to wear a CGM sensor
- Patients with insulin pumps
- Patients who already use a CGM
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Endoscopic Per-Oral Pyloromyotomy (POP)
The study cohort will include 40 patients with a HbA1c >7.5% with medically refractory gastroparesis who are scheduled to undergo POP.
Each patient will undergo two 10-day periods of CGM at an interval of approximately seven months, one month prior to the procedure and six months after.
Symptoms and diabetes management improvement will be measured by the Gastroparesis Cardinal Symptom Index (GCSI) scores and the Diabetes Self-Management Questionnaire (DSMQ).
|
Endoscopic Per-Oral Pyloromyotomy (POP)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from Baseline in Hemoglobin A1C levels
Time Frame: Baseline and 6 Month
|
Glycemic control will be evaluated by measuring change in Hemoglobin A1C (HbA1c) levels.
Poor glycemic control defined as an average HbA1c > 7.5%.
Change = (Six Month Score - Baseline Score)
|
Baseline and 6 Month
|
|
Change from Baseline in Glucose Levels measured by Continuous Glucose Monitor
Time Frame: Baseline and 6 Month
|
Glycemic control will be evaluated by measuring average glucose levels using Continuous Glucose Monitors (CGM).
Normal glucose levels 74-99 mg/dL.
Change = (Six Month Score - Baseline Score)
|
Baseline and 6 Month
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from Baseline on Diabetes Self-Management Questionnaire
Time Frame: Baseline and 6 Month
|
The Diabetes Self-Management Questionnaire (DSMQ) is a self reported instrument assessing diabetes self-care activities.
Possible scores range from 0 (Does not apply) to 3 (Applies to me very much).
Change = (Six Month Score - Baseline Score)
|
Baseline and 6 Month
|
|
Change from Baseline on Gastroparesis Cardinal Symptom Index
Time Frame: Baseline and 6 Month
|
The Gastroparesis Cardinal Symptom Index (GCSI) is a validated patient-administered questionnaire that is used to assess gastroparesis symptom severity.
Possible scores range from 0 (None) to 5 (Very Severe).
Change = (Six Month Score - Baseline Score)
|
Baseline and 6 Month
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Mathew Allemang, MD, The Cleveland Clinic
Publications and helpful links
General Publications
- Bailey TS, Chang A, Christiansen M. Clinical accuracy of a continuous glucose monitoring system with an advanced algorithm. J Diabetes Sci Technol. 2015 Mar;9(2):209-14. doi: 10.1177/1932296814559746. Epub 2014 Nov 3.
- Jung HK, Choung RS, Locke GR 3rd, Schleck CD, Zinsmeister AR, Szarka LA, Mullan B, Talley NJ. The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. Gastroenterology. 2009 Apr;136(4):1225-33. doi: 10.1053/j.gastro.2008.12.047. Epub 2008 Dec 24.
- Rodriguez J, Strong AT, Haskins IN, Landreneau JP, Allemang MT, El-Hayek K, Villamere J, Tu C, Cline MS, Kroh M, Ponsky JL. Per-oral Pyloromyotomy (POP) for Medically Refractory Gastroparesis: Short Term Results From the First 100 Patients at a High Volume Center. Ann Surg. 2018 Sep;268(3):421-430. doi: 10.1097/SLA.0000000000002927.
- Ramzan Z, Duffy F, Gomez J, Fisher RS, Parkman HP. Continuous glucose monitoring in gastroparesis. Dig Dis Sci. 2011 Sep;56(9):2646-55. doi: 10.1007/s10620-011-1810-z. Epub 2011 Jul 7.
- Tanenberg RJ, Pfeifer MA. Continuous glucose monitoring system: a new approach to the diagnosis of diabetic gastroparesis. Diabetes Technol Ther. 2000;2 Suppl 1:S73-80. doi: 10.1089/15209150050214168. No abstract available.
- Role of Continuous Glucose Monitoring in Diabetes Treatment. Arlington (VA): American Diabetes Association; 2018 Aug. Available from http://www.ncbi.nlm.nih.gov/books/NBK538971/
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 19-1460
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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