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. 46/62 (72%) completing 1 year post EB removal (age 51.5±7.7 years, 52% male, diabetes duration 14.5 (8-20) years, BMI 41.6±7.1 kg/m2) attended follow-up. During EB treatment, mean ± SD HbA1c fell by 1.9±1.8 %, from 9.2±1.8 to 7.2±1.0 % (p<0.001), weight by 17.2±8.8 kg from 121.9 ± 29.4 to 104.7±30.1 kg (<0.001), systolic BP from 139.0±14.0 to 126.0±14.6 mmHg (<0.001), serum alanine aminotransferase (marker of liver fat) from 30.0±16.9 to 18.8±11.0 U/L (p<0.001). Median (IQR) total daily insulin dose reduced from 104 (54-162) to 30 (0-62) units (n=31, p<0.001); 10/31 (32%) insulin treated patients discontinued insulin. One year after EB removal 18/46 (39%) demonstrated sustained improvement, 18/46 (39%) partially sustained improvement and 10/46 (22%) reverted to baseline (Figure). Of those deteriorating, 9/10 (90%) had depression and/or bereavement. 10/62 (16%) had early EB removal for adverse events or symptoms; all 10 fully recovered after removal and most derived significant benefit. Our data demonstrates EB as highly effective in patients with refractory diabesity, with maintenance of significant improvement 1 year after removal in 78%.


R.E.J. Ryder: Consultant; Self; GI Dynamics Inc. Other Relationship; Self; Novo Nordisk A/S. M. Yadagiri: None. S.P. Irwin: None. W. Burbridge: None. M.C. Wyres: None. T. Bashir: None. H. Gandhi: None. R. Allden: None. J. Bleasdale: None. E. Fogden: None. M. Anderson: None. P. Sen Gupta: None.

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