Gastric bypass with or without cutting the vagus nerve for type 2 diabetes
Compares two gastric bypass operations for type 2 diabetes in adults with obesity.
Plain-language title generated from the registry record
Registry title: Effects on Remission of Type 2 Diabetes Mellitus Following Gastric Bypass Alone vs Gastric Bypass Combined With Truncal Vagotomy
Key facts
- Where
- Athens, GreeceSee the site
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 68 years old?
Source: NCT07278115, who can take part
Where in Greece
- Diabetes SurgeryAthens, GreeceTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- University Research Institute for the Study of Genetic & Malignant Disorders in Childhood
- Trial code
- NCT07278115
- Record updated
- 30 April 2026
- Original description
This randomized, triple-blind clinical trial investigates whether adding truncal vagotomy to Roux-en-Y gastric bypass (RYGB) enhances remission of type 2 diabetes mellitus (T2DM) in patients with obesity. The study explores whether modulation of vagal signaling provides superior metabolic outcomes compared to standard RYGB alone.Read full original descriptionShow less
Effects on Remission of Type 2 Diabetes Mellitus Following Roux-en-Y Gastric Bypass Alone vs Roux-en-Y Gastric Bypass Combined With Truncal Vagotomy: A Triple-Blind Randomized Controlled Trial.
This randomized, triple-blind clinical trial investigates whether adding truncal vagotomy to Roux-en-Y gastric bypass (RYGB) enhances remission of type 2 diabetes mellitus (T2DM) in patients with obesity. The study explores whether modulation of vagal signaling provides superior metabolic outcomes compared to standard RYGB alone.
Background:
RYGB is a proven metabolic procedure capable of inducing diabetes remission; however, the mechanisms remain incompletely defined. Emerging evidence supports a duodenum-centered neurohormonal model suggesting that amplified digestion-driven by vagal and hormonal hyperstimulation-plays a key role in the development of insulin resistance. The vagus nerve regulates pancreatic and biliary secretion, as well as gut hormone release. By combining truncal vagotomy with RYGB, the study aims to attenuate vagal overactivation and evaluate its impact on glucose homeostasis and hormonal adaptation.
Design:
Eligible adults (18-65 years) with BMI ≥30 kg/m² and confirmed T2DM (HbA1c ≥6.5%, or on antidiabetic therapy with HbA1c ≥6.1%) will be randomized to:
1. RYGB alone, or 2. RYGB with truncal vagotomy. Participants, postoperative staff, and assessors will remain blinded to allocation.
Primary Outcome:
Remission of T2DM at 12 months postoperatively, defined as fasting plasma glucose <100 mg/dL and HbA1c <6.0% without antidiabetic medication for at least one year.
Secondary Outcomes:
Changes in HbA1c, fasting glucose, insulin, C-peptide, OGTT-derived indices, GLP-1, CCK, PYY, GLP-2, oxyntomodulin responses, HOMA-IR, body composition, cardiovascular risk markers, medication use, and quality-of-life parameters. Surgical metrics include hospital stay, readmissions, complications, gastrointestinal symptoms, nutritional deficiencies, and bone density changes.
Follow-Up:
Assessments occur preoperatively and at 1, 3, 6, and 12 months after surgery.
Significance:
The VagusSx Trial tests whether targeted vagal and duodenal pathway interruption can improve glycemic control beyond weight loss alone, offering a novel, physiology-based strategy for durable diabetes remission.
Inclusion: BMI ≥ 30 kg/m²; Age: 18-68 years; Confirmed type 2 diabetes mellitus with:; HbA1c ≥ 6.5%, or; HbA1c ≥ 6.1% and the use of antidiabetic medication; Advanced-DiaRem Score > 5* * Advanced-DiaRem Score: a validated scoring system predicting diabetes remission after bariatric surgery.
Exclusion: Previous bariatric surgery or major abdominal surgery (e.g., enterectomy, gastrectomy, colectomy, hepatectomy, partial or total pancreatectomy); Use of corticosteroids (glucocorticoids):; Chronic corticosteroid use for > 3 months within the last year, or; Corticosteroid therapy within the last 3 months; Alcohol or drug addiction; Major, uncompensated health problems (major psychiatric, endocrine, cardiac, pulmonary, hepatic, or renal disorder; cancer; or other conditions with increased risk of complications); Type 1 diabetes mellitus.