792 One Year Results of an Endoscopic, Duodenal-Jejunal Exclusion Device for Weight Loss and Control of Type 2 Diabetes (EndoBarrier)

Moura, Eduardo Guimarães Hourneaux de; Martins, Bruno Costa; Sauniti, Guilherme; Orso, Ivan Roberto Bonotto; Oliveira, Suzana L. De; Neto, Manoel Galvão; Mancini, Márcio C.; Santo, Marco Aurélio; Ramos, Almino Cardoso; Sakai, Paulo; Garrido-Junior, Arthur Belarmino; Halpern, Alfredo; Ivan, Cristina

doi:10.1016/j.gie.2011.03.122

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“…Contact of nutrients with the proximal intestinal mucosa is prevented, causing a delayed mix with bile and pancreatic secretions. Therapeutic effects of DJBL were shown in clinical studies during 3-6 months of application, and positive impact on metabolic control and hormonal effects in obese patients with T2DM was demonstrated [14][15][16][17][18][19][20][21][22][23]. However, to our best knowledge, a comprehensive analysis of changes in body composition, metabolic parameters, appetite regulation, coronary artery risk factors, satiety, and metabolic control associated with long-term application of DJBL over one year under real world conditions is outstanding.…”

Section: Introduction ▼mentioning

confidence: 99%

Beneficial Metabolic Effects of Duodenal Jejunal Bypass Liner for the Treatment of Adipose Patients with Type 2 Diabetes Mellitus: Analysis of Responders and Non-Responders

Stratmann

Krepak

Schiffer³

et al. 2016

Horm Metab Res

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Implantation of a duodenal-jejunal endoluminal bypass liner (DJBL) has shown to induce weight loss and to improve metabolic parameters. DJBL is a reversible endoduodenal sleeve mimicking duodenal bypass while lacking risks and limitations of bariatric surgery.Effects on metabolic control, body mass parameters, appetite regulation, glucose tolerance, organ health, and lipid profile were determined in 16 morbidly overweight patients with type 2 diabetes mellitus. In addition, relevant hormones (leptin, ghrelin, gastric inhibitory peptide, glucagon-like peptide, and insulin) were measured by enzyme-linked immunosorbent assay (ELISA) and chemiluminescent microparticle immunoassay (CMIA) at 0, 1, 32, and 52 weeks post-implant following a mixed meal tolerance test. Lipoprotein subclasses were analysed by proton nuclear magnetic resonance (H NMR) spectrometry. DJBL provoked weight loss, a decrease in fat mass, and an improvement in insulin resistance and hepatic function in most but not all of the patients, but in the long term did not increase gut hormone fasting levels pointing to a combined effect of more than gut parameters alone. Lipidome analysis was done in 10 patients, allowing classification to responders and non-responders by reduction of sLDL-p subfraction; and to further analyse the atherogenic profile. Responders showed an overall more pronounced effect regarding improvement of HbA1c, BMI, and HOMA index.Implantation of a DJBL in obese type 2 diabetes patients does not per se lead to an improvement of the metabolic situation. Further analyses including larger cohorts have to be performed to identify responding patients, to better treat non-responders and to analyse the key effectors.

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