EB, a 60cm endoscopically implanted proximal intestinal liner, reduces weight and HbA1c over 1 year. In the 1st NHS EB service, we provided EB for patients with sub optimally controlled diabesity and monitored outcomes in a registry. The 1st 38 patients have completed 6 months post EB removal and of these 31/38 (82%) (age 51.4 ± 6.8 years, 51.6% male, diabetes duration 12 (6-21) years) attended follow-up. During EB implant, mean ± SD HbA1c fell by 2.5 ± 2.0%, from 10.0 ± 2.0 to 7.5 ± 1.2% (p<0.001), weight by 15.8 ± 9.0 kg from 120.6 ± 27.6 to 104.9 ± 28.9 kg (<0.001), systolic BP from 138.3 ± 15.6 to 123.0 ± 14.6 mmHg (<0.001), serum alanine-aminotransferase (ALT-marker of liver fat) from 29.7 ± 17.6 to 19.6 ± 11.5 U/L (p<0.001). Median (IQR) total daily insulin dose reduced from 102 (48-129) to 25 (0-59) units (p<0.001), n=20. 6 months post EB explant 21/31 (68%) had maintained the improvement and this was reflected in the figures for the group as a whole (Table). 7/20 (35%) insulin treated patients discontinued insulin. Of the 10 whose weight and/or HbA1c deteriorated, 7/10(75%) had depression. 4/38 (10.5%) patients had early Endobarrier-removal: 3 GI bleed, 1 liver abscess (Table). All 4 had full recovery after removal. All other patients achieved a full year of EB treatment. Our data demonstrates EB as highly effective in patients with refractory diabesity, with maintenance of improvement after removal in 68%.
R.E.J. Ryder: Other Relationship; Self; AstraZeneca. Speaker's Bureau; Self; Bioquest, Janssen Pharmaceuticals, Inc.. Other Relationship; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Novo Nordisk A/S. M. Yadagiri: None. S.P. Irwin: None. W. Burbridge: Other Relationship; Self; Menarini Group. M.C. Wyres: None. H. Gandhi: None. M.L. Cull: None. R. Allden: None. J. Bleasdale: None. E. Fogden: None. M. Anderson: None. P. Sen Gupta: None.
© 2018 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.