EB, a 60cm endoscopically inserted proximal intestinal liner, reduces weight and HbA1c over 1-year. In the 1st NHS EB service, we provided EB to patients with sub optimally controlled diabesity and monitored outcomes in a registry. 32/46 (70%) completing 1-year post EB removal (age 51.1±7.5 years, 56% male, diabetes duration 14 (8-21) years, BMI 41.7±7.8 kg/m2) attended follow-up. During EB treatment, mean ± SD HbA1c fell by 2.1±1.9%, from 9.5±1.9 to 7.4±1.1% (p<0.001), weight by 17.0±8.9 kg from 121.1 ± 28.4 to 104.1±29.1 kg (<0.001), systolic BP from 140.0±15.3 to 126.4±15.9 mmHg (<0.001), serum alanine aminotransferase (marker of liver fat) from 29.1±17.7 to 18.2±9.7 U/L (p<0.001). Median (IQR) total daily insulin dose reduced from 104 (60-140) to 20 (0-59) units (n=21, p<0.001); 7/21 (33%) insulin treated patients discontinued insulin. 1-year post EB removal 13/32 (41%) demonstrated sustained improvement with 12/32 (37%) partially sustaining improvement and 7/32 (22%) reverting to baseline (Figure). Of those deteriorating, 6/7 (86%) had depression and/or bereavement. 41/46 (89%) achieved the planned full year of EB treatment but 5/46 (11%) had early EB removal (4 GI bleed, 1 liver abscess) with all 5 fully recovering after removal. Our data demonstrates EB as highly effective in patients with refractory diabesity, with maintenance of significant improvement 1-year after removal in 78%.

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Disclosure

R.E.J. Ryder: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Bioquest. P. Sen Gupta: None. M. Yadagiri: None. S.P. Irwin: Speaker's Bureau; Self; AstraZeneca. W. Burbridge: None. T. Bashir: None. M.C. Wyres: None. R. Allden: None. J. Bleasdale: None. E. Fogden: None. M. Anderson: None.

© 2019 by the American Diabetes Association.
2019
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