The impact of <scp>EndoBarrier</scp> gastrointestinal liner in obese patients with normal glucose tolerance and in patients with type 2 diabetes

Rohde, Ulrich; Federspiel, Cecilie A.; Vilmann, Peter; Langholz, Ebbe; Friis, Stine; Krakauer, Martin; Rehfeld, Jens F.; Holst, Jens J.; Vilsbøll, Tina; Knop, Filip K.

doi:10.1111/dom.12800

Cited by 24 publications

(12 citation statements)

References 48 publications

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“…Type 2 diabetes patients receiving a Duodenal Jejunal Bypass Sleeve (DJBS), also known as Endobarrier, had significant improvement of insulin resistance, higher postprandial GLP-1 and unchanged GIP [57]. Results from a small single-armed prospective study using Duodenal Mucosal Resurfacing, showed a mean improvement of glycemic control with a decreased Hba1c of §1%.…”

Section: Incretins After Endoscopic Bariatric Proceduresmentioning

confidence: 99%

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

Olst

Meiring

Brauw

et al. 2020

Techniques and Innovations in Gastrointestinal Endoscopy

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Incretins, bile acids and the gut microbiome are involved in the pathophysiology of obesity and type 2 diabetes. The incretins glucagon-like peptide-1 and glucose-dependent-insulinetrophic polypeptide, both influence beta-cell function, insulin and glucose sensitivity, and food intake. Studies have shown that concentrations of both incretins change after bariatric surgery and nowadays glucagon-like peptide-1 agonists are administered as glucose and body weight regulating agents. Bile acids also play an important role in glycemic and metabolic regulation via multiple signaling pathways. After bariatric surgical interventions increase in bile acid concentrations have been observed combined with improvement of metabolic health. It is not clear though, whether this is a direct effect of the altered concentration of bile acids or an epiphenomenon. In addition, alterations in the microbiome are seen in patients with type 2 diabetes and people with obesity. The gut microbiome, probably together with incretins and bile acids, is essential in digestion and nutrient metabolism. After bariatric procedures several alterations in bacterial abundance have been demonstrated with specific bacterial species having different effects on glycemic and metabolic conditions

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Section: Incretins After Endoscopic Bariatric Proceduresmentioning

confidence: 99%

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

Olst

Meiring

Brauw

et al. 2020

Techniques and Innovations in Gastrointestinal Endoscopy

View full text Add to dashboard Cite

show abstract

“…Rohde et al compared the effect of the EndoBarrier on postprandial physiology in 10 obese patients with normal glucose tolerance (NGT) and 9 age-, body weight-, and BMI-matched patients with T2DM. Parameters investigated included insulin, glucose, glucagon, gut hormone secretion, gall bladder emptying, and appetite and food intake using liquid mixed meal test and a subsequent ad libitum meal test at baseline, 1 week and 26 weeks following EndoBarrier implantation [ 22 ]. Basal plasma concentrations of GLP-1, GIP, and PYY were similar in the two groups before EndoBarrier implantation, and the device did not appear to affect basal concentrations significantly in any of the groups.…”

Section: Potential Mechanisms Of Actionmentioning

confidence: 99%

The EndoBarrier: Duodenal-Jejunal Bypass Liner for Diabetes and Weight Loss

Ruban

Ashrafian

Teare

2018

Gastroenterology Research and Practice

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The rapid rise of obesity and type 2 diabetes poses a global threat to healthcare and is a major cause of mortality and morbidity. Bariatric surgery has revolutionised the treatment of both these conditions but is invasive and associated with an increased risk of complications. The EndoBarrier is a device placed endoscopically in the duodenum, which is designed to mimic the effects of gastric bypass surgery with the aim of inducing weight loss and improving glycaemic control. This review outlines the current clinical evidence of the device, its efficacy, potential mechanisms of action, and utility in clinical practice.

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“…Similarly, a recent case series study of patients with obesity and T2DM demonstrated reduced food intake at 36 weeks after the Endobarrier implant using a semi-quantitative Food Frequency Questionnaire [ 11 ]. In contrast, a prospective observational study of two groups, a group of patients with obesity and normal glucose-tolerance, and another group of matched metformin-treated patients T2DM who underwent Endobarrier implant, demonstrated lower food intake only at one week [ 12 ]. This was followed by a return to baseline food intake at explantation (26 weeks), despite ongoing weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…This was the only human study so far to use an ad libitum meal to assess food intake. Of note, this study also did not include a control group for comparison [ 12 ]. Among animal models, a study comparing food intake between diet-induced obese rats after endoluminal sleeve insertion and sham-operated controls showed reduced food intake in the sleeve group compared to no change in the control group at eight weeks [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Does Bypass of the Proximal Small Intestine Impact Food Intake, Preference, and Taste Function in Humans? An Experimental Medicine Study Using the Duodenal-Jejunal Bypass Liner

et al. 2022

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The duodenal-jejunal bypass liner (Endobarrier) is an endoscopic treatment for obesity and type 2 diabetes mellitus (T2DM). It creates exclusion of the proximal small intestine similar to that after Roux-en-Y Gastric Bypass (RYGB) surgery. The objective of this study was to employ a reductionist approach to determine whether bypass of the proximal intestine is the component conferring the effects of RYGB on food intake and sweet taste preference using the Endobarrier as a research tool. A nested mechanistic study within a large randomised controlled trial compared the impact of lifestyle modification with vs. without Endobarrier insertion in patients with obesity and T2DM. Forty-seven participants were randomised and assessed at several timepoints using direct and indirect assessments of food intake, food preference and taste function. Patients within the Endobarrier group lost numerically more weight compared to the control group. Using food diaries, our results demonstrated similar reductions of food intake in both groups. There were no significant differences in food preference and sensory, appetitive reward, or consummatory reward domain of sweet taste function between groups or changes within groups. In conclusion, the superior weight loss seen in patients with obesity and T2DM who underwent the Endobarrier insertion was not due to a reduction in energy intake or change in food preferences.

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The impact of EndoBarrier gastrointestinal liner in obese patients with normal glucose tolerance and in patients with type 2 diabetes

Abstract: DJBS-induced weight loss was associated with only marginal changes in postprandial physiology, which may explain the absence of effect on postprandial glucose metabolism.

Cited by 24 publications

References 48 publications

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

Small intestinal physiology relevant to bariatric and metabolic endoscopic therapies: Incretins, bile acid signaling, and gut microbiome

The EndoBarrier: Duodenal-Jejunal Bypass Liner for Diabetes and Weight Loss

Does Bypass of the Proximal Small Intestine Impact Food Intake, Preference, and Taste Function in Humans? An Experimental Medicine Study Using the Duodenal-Jejunal Bypass Liner

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