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Published in: Obesity Surgery 2/2016

01-02-2016 | Original Contributions

Duodenal Electric Stimulation

Results of a First-in-Man Study

Authors: Jens Aberle, Philipp Busch, Jochen Veigel, Anna Duprée, Thomas Roesch, Christine zu Eulenburg, Björn Paschen, Bernd M. Scholz, Stefan Wolter, Nina Sauer, Kaja Ludwig, Jakob Izbicki, Oliver Mann

Published in: Obesity Surgery | Issue 2/2016

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Abstract

Background

The aim of this study was to demonstrate feasibility and safety of a new electric duodenal stimulation system (EDS, BALANCE) in humans. Secondary objectives were to evaluate the effect on glycemic control and weight loss in patients with obesity and type 2 diabetes mellitus (T2DM).

Methods

In an open-labeled, prospective, single-arm, non-randomized multicenter study, 12 obese T2DM patients with a mean HbA1c of 8.0 % received laparoscopic implantation of the BALANCE duodenal stimulating device. Adverse events, changes in glycemic control, cardiovascular parameters, and weight were collected. The follow-up period after implantation was 12 months.

Results

Device related severe adverse events did not occur. Mean HbA1c decreased by 0.8 % (p = 0.02) and mean fasting blood glucose level (FBG) was reduced by 19 % (p = 0.038) after the 12 months. Mean HDL level increased from 44 to 48 mg/dl (p = 0.033).

Conclusions

EDS is a feasible and safe procedure. Positive effects on T2DM and some cardiovascular parameters (HDL, weight) were seen. However, further prospective randomized blinded studies are needed in order to evaluate the potential of this new minimally invasive method.
Literature
1.
go back to reference Chan JC et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301:2129.PubMedCrossRef Chan JC et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301:2129.PubMedCrossRef
2.
go back to reference Pories WJ, Caro JF, Flickinger EG, et al. The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass. Ann Surg. 1987;206:316.PubMedPubMedCentralCrossRef Pories WJ, Caro JF, Flickinger EG, et al. The control of diabetes mellitus (NIDDM) in the morbidly obese with the Greenville Gastric Bypass. Ann Surg. 1987;206:316.PubMedPubMedCentralCrossRef
3.
go back to reference Buchwald H et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122:248.PubMedCrossRef Buchwald H et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122:248.PubMedCrossRef
5.
go back to reference Laferrere B et al. Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes. J Clin Endocrinol Metab. 2008;93:2479.PubMedPubMedCentralCrossRef Laferrere B et al. Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes. J Clin Endocrinol Metab. 2008;93:2479.PubMedPubMedCentralCrossRef
6.
go back to reference Zhang J, Chen JD. Systematic review: applications and future of gastric electrical stimulation. Aliment Pharmacol Ther. 2006;24:991.PubMedCrossRef Zhang J, Chen JD. Systematic review: applications and future of gastric electrical stimulation. Aliment Pharmacol Ther. 2006;24:991.PubMedCrossRef
7.
go back to reference Xing JH, Lei Y, Ancha HR, et al. Effect of acute gastric electrical stimulation on the systemic release of hormones and plasma glucose in dogs. Dig Dis Sci. 2007;52:495.PubMedCrossRef Xing JH, Lei Y, Ancha HR, et al. Effect of acute gastric electrical stimulation on the systemic release of hormones and plasma glucose in dogs. Dig Dis Sci. 2007;52:495.PubMedCrossRef
8.
go back to reference Cigaina V. Long-term follow-up of gastric stimulation for obesity: the Mestre 8-year experience. Obes Surg. 2004;14 Suppl 1:S14.PubMedCrossRef Cigaina V. Long-term follow-up of gastric stimulation for obesity: the Mestre 8-year experience. Obes Surg. 2004;14 Suppl 1:S14.PubMedCrossRef
9.
go back to reference Khawaled R, Blumen G, Fabricant G, et al. Intestinal electrical stimulation decreases postprandial blood glucose levels in rats. Surg Obes Relat Dis. 2009;5:692.PubMedCrossRef Khawaled R, Blumen G, Fabricant G, et al. Intestinal electrical stimulation decreases postprandial blood glucose levels in rats. Surg Obes Relat Dis. 2009;5:692.PubMedCrossRef
10.
go back to reference Liu S, Hou X, Chen JD. Therapeutic potential of duodenal electrical stimulation for obesity: acute effects on gastric emptying and water intake. Am J Gastroenterol. 2005;100:792.PubMedCrossRef Liu S, Hou X, Chen JD. Therapeutic potential of duodenal electrical stimulation for obesity: acute effects on gastric emptying and water intake. Am J Gastroenterol. 2005;100:792.PubMedCrossRef
11.
go back to reference Shikora SA. Implantable gastric stimulation—the surgical procedure: combining safety with simplicity. Obes Surg. 2004;14 Suppl 1:S9.PubMedCrossRef Shikora SA. Implantable gastric stimulation—the surgical procedure: combining safety with simplicity. Obes Surg. 2004;14 Suppl 1:S9.PubMedCrossRef
12.
go back to reference Bohdjalian A et al. One-year experience with Tantalus: a new surgical approach to treat morbid obesity. Obes Surg. 2006;16:627.PubMedCrossRef Bohdjalian A et al. One-year experience with Tantalus: a new surgical approach to treat morbid obesity. Obes Surg. 2006;16:627.PubMedCrossRef
13.
go back to reference Chen JZ, Ueno T, Xu X, et al. Reverse gastric pacing reduces food intake without inducing symptoms in dogs. Scand J Gastroenterol. 2006;41:30.PubMedCrossRef Chen JZ, Ueno T, Xu X, et al. Reverse gastric pacing reduces food intake without inducing symptoms in dogs. Scand J Gastroenterol. 2006;41:30.PubMedCrossRef
14.
go back to reference Liu J, Qiao X, Hou X, et al. Effect of intestinal pacing on small bowel transit and nutrient absorption in healthy volunteers. Obes Surg. 2009;19:196.PubMedCrossRef Liu J, Qiao X, Hou X, et al. Effect of intestinal pacing on small bowel transit and nutrient absorption in healthy volunteers. Obes Surg. 2009;19:196.PubMedCrossRef
15.
16.
go back to reference Layzell T, Collin J. Retrograde electrical pacing of the small intestine—a new treatment for the short bowel syndrome? Br J Surg. 1981;68:711.PubMedCrossRef Layzell T, Collin J. Retrograde electrical pacing of the small intestine—a new treatment for the short bowel syndrome? Br J Surg. 1981;68:711.PubMedCrossRef
17.
go back to reference Cullen JJ, Doty RC, Ephgrave KS, et al. Changes in intestinal transit and absorption during endotoxemia are dose dependent. J Surg Res. 1999;81:81.PubMedCrossRef Cullen JJ, Doty RC, Ephgrave KS, et al. Changes in intestinal transit and absorption during endotoxemia are dose dependent. J Surg Res. 1999;81:81.PubMedCrossRef
18.
go back to reference Huge A, Weber E, Ehrlein HJ. Effects of enteral feedback inhibition on motility, luminal flow, and absorption of nutrients in proximal gut of minipigs. Dig Dis Sci. 1995;40:1024.PubMedCrossRef Huge A, Weber E, Ehrlein HJ. Effects of enteral feedback inhibition on motility, luminal flow, and absorption of nutrients in proximal gut of minipigs. Dig Dis Sci. 1995;40:1024.PubMedCrossRef
19.
go back to reference Gibbs J, Young RC, Smith GP. Cholecystokinin decreases food intake in rats. J Comp Physiol Psychol. 1973;84:488.PubMedCrossRef Gibbs J, Young RC, Smith GP. Cholecystokinin decreases food intake in rats. J Comp Physiol Psychol. 1973;84:488.PubMedCrossRef
21.
go back to reference Xu J, McNearney TA, Chen JD. Gastric/intestinal electrical stimulation modulates appetite regulatory peptide hormones in the stomach and duodenum in rats. Obes Surg. 2007;17:406.PubMedCrossRef Xu J, McNearney TA, Chen JD. Gastric/intestinal electrical stimulation modulates appetite regulatory peptide hormones in the stomach and duodenum in rats. Obes Surg. 2007;17:406.PubMedCrossRef
23.
go back to reference Redmon JB et al. One-year outcome of a combination of weight loss therapies for subjects with type 2 diabetes: a randomized trial. Diabetes Care. 2003;26:2505–11.PubMedCrossRef Redmon JB et al. One-year outcome of a combination of weight loss therapies for subjects with type 2 diabetes: a randomized trial. Diabetes Care. 2003;26:2505–11.PubMedCrossRef
Metadata
Title
Duodenal Electric Stimulation
Results of a First-in-Man Study
Authors
Jens Aberle
Philipp Busch
Jochen Veigel
Anna Duprée
Thomas Roesch
Christine zu Eulenburg
Björn Paschen
Bernd M. Scholz
Stefan Wolter
Nina Sauer
Kaja Ludwig
Jakob Izbicki
Oliver Mann
Publication date
01-02-2016
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2016
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1774-8

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