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01-07-2017

Weight reduction and improvement in diabetes by the duodenal-jejunal bypass liner: a 198 patient cohort study

Authors: Bark Betzel, Jens Homan, Edo O. Aarts, Ignace M. C. Janssen, Hans de Boer, Peter J. Wahab, Marcel J. M. Groenen, Frits J. Berends

Published in: Surgical Endoscopy | Issue 7/2017

Abstract

Background

The duodenal-jejunal bypass liner (DJBL) is an endoscopic treatment for patients with type 2 diabetes mellitus (T2DM) and (morbid) obesity. The aim of the current study was to determine its efficacy and safety profile.

Methods

Inclusion criteria for treatment with a DJBL were: age 18–70 years, BMI 28–45 kg/m², and T2DM with a HbA1c > 48 mmol/mol. Primary outcomes were changes in HbA1c and body weight. Secondary outcomes included changes in blood pressure, lipids, and anti-diabetic medication. Predictive factors for success of treatment with the DJBL were determined.

Results

Between 2011 and 2014, 185 out of 198 patients successfully underwent a DJBL implantation procedure, with an intended implantation time of 12 months. In these 185 patients, body weight decreased by 12.8 ± 8.0 kg (total body weight loss of 11.9 ± 6.9 %, p < 0.001), HbA1c decreased from 67 to 61 mmol/mol (p < 0.001) despite a reduction in anti-diabetic medication, and blood pressure and serum lipid levels all decreased. In total, 57 (31 %) DJBLs were explanted early after a median duration of 33 weeks. Adverse events occurred in 17 % of patients. C-peptide ≥1.0 nmol/L and body weight ≥107 kg at screening were independent predictive factors for success.

Conclusions

Treatment with the DJBL in T2DM patients with (morbid) obesity results in improvement in glucose control, a reduction in anti-diabetic medication, and significant weight loss. The largest changes are observed within the first 3–6 months. Initial C-peptide levels and body weight may help to select patients with the greatest chance of success.

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Title: Weight reduction and improvement in diabetes by the duodenal-jejunal bypass liner: a 198 patient cohort study
Authors: Bark Betzel
Jens Homan
Edo O. Aarts
Ignace M. C. Janssen
Hans de Boer
Peter J. Wahab
Marcel J. M. Groenen
Frits J. Berends
Publication date: 01-07-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 7/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5299-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Weight reduction and improvement in diabetes by the duodenal-jejunal bypass liner: a 198 patient cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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