Treatment with the duodenal jejunal bypass liner (DJBL) - EndoBarrier - reduced microvascular and macrovascular risk factors that could reduce the complications of type 2 diabetes (T2D), according to the latest data from the Association of British Clinical Diabetologists (ABCD) Worldwide EndoBarrier Registry. The findings show improvements in weight, glycaemic control, blood pressure and cholesterol.
The duodenal-jejunal bypass liner was developed to mimic the small-bowel mechanisms of Roux-en-Y gastric bypass while being less invasive. Over 3,000 patients have been treated with EndoBarrier worldwide, and in 2017 a secure, online registry was established by ABCD for the collection of safety and efficacy data for EndoBarrier treated patients worldwide.
The ABCD Worldwide EndoBarrier Registry, led by Dr Robert Ryder of City Hospital, Birmingham, UK, collected data from 34 centres in ten countries. As of October 2022, data had been entered on 1,022 patients and continues to support a positive benefit:risk profile for patients with type 2 diabetes and/or obesity treated with EndoBarrier.
"There is an increasing number of patients with refractory uncontrolled T2D and obesity worldwide with no readily available treatment option, and the potential demand is too great for available metabolic surgery resources,” said Ryder. “The overall clinical benefit of EndoBarrier is highlighted in the Worldwide Registry data analyses demonstrating clinically significant reductions in weight during EndoBarrier implantation and additional associated improvements in HbA1c, blood pressure and cholesterol. This reduction in microvascular and macrovascular risk factors could serve to reduce the overall complications associated with type 2 diabetes."
As shown below, EndoBarrier treatment was associated with considerable reduction in weight, HbA1c, systolic blood pressure and cholesterol:
Analysis of the data according to baseline HbA1c clearly shows the higher the initial HbA1c the greater the reduction with EndoBarrier treatment. Similarly, the study showed the higher the initial BMI, the greater the reduction. There were no differences in HbA1c or weight reduction by age or sex.
"The Worldwide Registry continues to demonstrate the positive impact of EndoBarrier on behalf of patients suffering from T2D and obesity,” commented Joe Virgilio, President and CEO of GI Dynamics. “The clinical benefits we have seen are compelling and reinforce our belief that EndoBarrier has the potential to offer a less invasive, reversible option compared to traditional bariatric surgeries. The resulting therapeutic benefits could dramatically enhance the lives of these high-risk patients.
The findings were featured in the paper, "Endoscopic Duodenal-Jejunal Bypass Liner Treatment for Type 2 Diabetes and Obesity: Glycemic and Cardiovascular Disease Risk Factor Improvements in 1,022 Patients Treated Worldwide," published in Diabetes Care. To access this paper, please click here
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