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Insulin therapy

EndoBarrier eliminates or reduces insulin therapy

Five insulin-treated patients were also able to decrease their insulin therapy in injection frequency, daily dosage or both

EndoBarrier Therapy resulted in a rapid reduction in, and elimination of, insulin therapy by patients with type 2 diabetes and obesity, according to findings from a retrospective analysis of 100 patients in Australia presented at the American Association for Clinical Endocrinology 23rd Annual Meeting and Scientific Congress in Las Vegas.

“While based on a small number of patients, these findings show that EndoBarrier Therapy has a real, immediate impact on glycaemic levels,” said Professor Reginald V Lord, St. Vincent’s Clinic and Macquarie Hospital, Sydney. “We are pleased that EndoBarrier Therapy offers the opportunity for patients to reduce their reliance on insulin, which is often viewed as a last resort treatment for diabetes. We view EndoBarrier Therapy as a non-surgical treatment option that possibly extends the utility of their existing pharmaceutical treatment regimens.”

The retrospective analysis reviewed the medical records and nationwide patient registry of the first 100 patients in Australia who received EndoBarrier Therapy. Of these 100 patients, 11 required the use of insulin to manage their type 2 diabetes prior to receiving EndoBarrier Therapy. Following placement of the EndoBarrier, there was an overall lowering of insulin requirements based on the protocol at the two treatment centers.

The analysis revealed that six (54%) of the 11 insulin-treated patients with type 2 diabetes were able to completely cease use of insulin therapy during EndoBarrier Therapy. The remaining five insulin-treated patients were also able to decrease their insulin therapy in injection frequency, daily dosage or both. All patients maintained use of oral diabetes medications.

Moreover, this overall reduction in concomitant insulin use was accompanied by a lowering of HbA1c to 7.3%, from a HbA1c of 8.8% at baseline. The analysis also demonstrated the positive effects of EndoBarrier Therapy on weight; patients achieved a median weight loss of 11.1kg at study follow up.

“Earlier research has demonstrated that EndoBarrier Therapy has rapid and sustained effects on glycaemic control and this analysis further supports those findings,” said Dr David Maggs, chief medical officer of GI Dynamics. “As we expand our global patient experience, we are learning more about how EndoBarrier Therapy can help reduce or, in some cases, altogether eliminate the use of insulin in those patients who have progressed to requiring insulin treatment. Based on the data and patient experience to date, we believe EndoBarrier Therapy is emerging as a highly attractive complement to existing pharmaceutical regimens and an important treatment option to consider for people with type 2 diabetes and obesity.”

The EndoBarrier is a flexible, tube-shaped liner that is inserted endoscopically and placed at the beginning of the small intestine, where it remains for up to one year; after which it is removed during another endoscopic procedure. It is currently under investigation in the US in a multicentre, pivotal clinical trial (The ENDO Trial) for the treatment of patients who have uncontrolled type 2 diabetes and are obese. EndoBarrier has been approved in select countries internationally since 2010 and is available in Chile, Australia and a growing number of countries in Europe and the Middle East. The EndoBarrier is not approved for sale in the US.

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