Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Prospective Randomized Controlled Trial on the Effect of Gastric Bypass and Biliopancreatic Diversion on Type 2 Diabetes Mellitus in Patients With BMI > 35 vs. Medical Therapy
Brief Summary: It is generally held that ß-cell function is irreversibly lost already at the time the disease manifests itself and thereafter continues to decline linearly with time. Several studies, however, have documented the possibility that ß-cell function may be restored, at least partially, in type 2 diabetes. Of major relevance to the issue of ß-cell recovery in diabetes are the following findings:

* bariatric surgery in morbidly obese patients with type 2 diabetes can restore euglycaemia, the acute insulin response to glucose and insulin sensitivity;
* recent studies have reported that diabetic subjects return to euglycaemia and normal insulin levels within days after surgery, long before a significant weight loss has occurred; and
* whereas gastric bypass (GBP) improves insulin sensitivity in proportion to weight loss, bilio-pancreatic diversion (BPD) improves insulin action out of proportion to weight loss, i.e., it normalizes it at a time when patients are still markedly obese. Because RYGB is a predominantly restrictive procedure involving the foregut, whereas BPD is a predominantly malabsorptive procedure involving the distal gastro-intestinal (GI) tract, these findings suggest that the control of both insulin action and ß-cell function is influenced by signals originating from the GI tract.

The principal aim of this study is to verify the effect on type 2 diabetes mellitus (T2DM) of GBP and BPD, the two operations which have shown specific actions on glucose homeostasis control, in type 2 diabetic patients with BMI \> 35 kg/m2, and to compare this effect with matched T2DM control patients receiving the standard of medical care.


Options:
A: Arm Label: Medical therapy; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Gastric Bypass; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Gastric bypass | Arm Label: Sleeve Gastrectomy; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Sleeve Gastrectomy | Intervention Type: PROCEDURE; Name: Gastric bypass; Assigned to Arm(s): Gastric Bypass | Intervention Type: PROCEDURE; Name: Sleeve Gastrectomy; Assigned to Arm(s): Sleeve Gastrectomy
B: Arm Label: GBP; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Bariatric surgery: Gastric bypass | Arm Label: BPD 2; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Bariatric surgery: Bilio-pancreatic diversion | Arm Label: Med Ter3; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: anti-diabetic drugs and behavioral suggestions | Intervention Type: PROCEDURE; Name: Bariatric surgery: Gastric bypass; Assigned to Arm(s): GBP | Intervention Type: PROCEDURE; Name: Bariatric surgery: Bilio-pancreatic diversion; Assigned to Arm(s): BPD 2 | Intervention Type: BEHAVIORAL; Name: anti-diabetic drugs and behavioral suggestions; Assigned to Arm(s): Med Ter3
C: Arm Label: 1; Type: EXPERIMENTAL; Interventions: Procedure: Laparoscopic Biliopancreatic diversion with Duodenal switch | Arm Label: 2; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Laparoscopic Roux-en-Y Gastric Bypass | Intervention Type: PROCEDURE; Name: Laparoscopic Biliopancreatic diversion with Duodenal switch; Assigned to Arm(s): 1 | Intervention Type: PROCEDURE; Name: Laparoscopic Roux-en-Y Gastric Bypass; Assigned to Arm(s): 2
D: Arm Label: 1; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: 2; Type: ACTIVE_COMPARATOR; Interventions: Procedure: gastric bypass | Arm Label: 3; Type: ACTIVE_COMPARATOR; Interventions: Procedure: sleeve gastrectomy | Intervention Type: PROCEDURE; Name: gastric bypass; Assigned to Arm(s): 2 | Intervention Type: PROCEDURE; Name: sleeve gastrectomy; Assigned to Arm(s): 3

Answer: B