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Endoscopically implanted device safe, effective in obesity, type 2 diabetes
A duodenal-jejunal bypass liner was safe and effective in treating adults with obesity and type 2 diabetes and may serve as an alternative to bariatric surgery for some patients, according to findings published in Obesity Surgery.
The duodenal-jejunal bypass liner (EndoBarrier, GI Dynamics) is a thin plastic sleeve that lines the first 60 cm of the small intestine, causing food to be absorbed further down in the intestine, according to a description from the manufacturer.
Julian Teare, MD, FRCP, professor of gastroenterology in the department of surgery and cancer at Imperial College London, and colleagues evaluated data on 31 adults with obesity and type 2 diabetes (mean age, 49.9 years; 48.9% men; mean BMI, 40 kg/m2; mean duration of diabetes, 4.6 years) treated with the duodenal-jejunal bypass liner to determine its safety and efficacy. The device was implanted for 12 months, and participants were followed for 6 months after the implant was removed.
Mild device-related adverse events occurred in 84.4% of participants.
Twelve months after device insertion, mean weight loss was 15 kg (P < .05) from baseline and was most rapid within the first 3 months after insertion. Participants experienced reductions in BMI from baseline at 6 months (mean difference, 3.96 kg/m2; P < .05), 9 months (mean difference, 4.6 kg/m2; P < .05) and 12 months (mean difference, 4.9 kg/m2; P < .005). Mean weight was increased by 2.2 kg at 3 months and 3.1 kg at 6 months after device removal; however, BMI was not significantly increased after device removal at 3 or 6 months.
Mean HbA1c was 0.8% lower at 12 months compared with the mean baseline (P < .05); reductions were observed at 3 months (0.9%; P < .05) and further decreased at 6 months (1%; P < .005) and 12 months (1.2%; P < .00001). HbA1c remained stable following device removal.
“Increasingly, patients and physicians are looking toward minimally invasive techniques as an alternative to conventional surgery to treat chronic diseases,” the researchers wrote. “The EndoBarrier is a device easily implanted and explanted without incisions, reducing complications, time, cost and recovery associated with conventional treatment modalities. Any measures to reduce these whilst maintaining or improving the patient treatment experience and post-procedure quality of life by the omission of surgery should be further explored.” – by Amber Cox
Disclosures: Teare reports he received travel fees from GI Dynamics. Please see the study for all other authors’ relevant financial disclosures.