Diabetologie und Stoffwechsel 2014; 9 - P231
DOI: 10.1055/s-0034-1375088

Treatment of type 2 diabetes mellitus with the endoscopic duodenal-jejunal bypass liner (EndoBarrier®)

K Laubner 1, L Potasso 1, N Perakakis 1, H Schwacha 2, J Seufert 1
  • 1University Hospital of Freiburg, Internal Medicine II, Endocrinology/Diabetology, Freiburg, Germany
  • 2University Hospital of Freiburg, Internal Medicine II, Gastroenterology, Freiburg, Germany

Background: The duodenal-jejunal bypass liner (DJBL) is an endoscopically delivered and removable device creating a duodenal-jejunal bypass thereby mimicking Roux-en-Y and Duodenal-Jejunal Bypass procedures. The DJBL is indicated for the treatment of type 2 Diabetes (T2Dm) and obesity. Here we report interim results of the ongoing data collection of patients treated with this procedure.

Methods: We implanted in 26 subjects with T2Dm (f:m 21:5, 46,3 y) on various medications, a mean baseline HbA1c of 7,7% and BMI of 44,7 kg/m2 a DJBL. AEs as well as anthropometric, metabolic and cardiovascular risk parameters were monitored every 3 months. Further we used the “Freiburg Metabolism Score” (FMS) to characterize metabolic control in response to glucose lowering therapy.

Results: In comparison to baseline, HbA1c was reduced from 7,7% to 6,7% with simultaneous reduction of antidiabetic medication. According to the FMS, more than 80% had a benefit with respect to their metabolic control. Mean BMI was reduced to 38,5 kg/m2, corresponding to an EWL of 24,5%. LDL and parameters of NAFDL decreased also. The most common AEs were abdominal pain and nausea especially in the first two weeks. We observed one duodenal perforation which was successfully treated by minimal invasive surgery.

Conclusion: The DJBL is a safe and effective endoscopic device which improves glycemic control, body weight and related metabolic and cardiovascular risk-parameters in obese T2Dm patients. Individual response to the DJBL is variable, depending on patients compliance. The DJBL may represent an alternative or adjunct to bariatric surgery to treat T2Dm in obese patients.