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.

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