EndoBarrier implant could revolutionise type 2 diabetes treatment

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A combination of medication, diet and exercise is what normally is prescribed to type 2 diabetes patients, but surgeons at the Southampton General Hospital are looking to test the potential of EndoBarrier implant, which has more potential than medicines.

EndoBarrier is basically a small device – made from fluoropolymer, a material known for its high resistance to acids – that is placed into the small intestine of patients via the mouth for up to 12 months. EndoBarrier effectively acts as a barrier preventing food from being absorbed and ensures it bypasses a section of the upper intestine, allowing less time for digestion and improving the resistance to insulin.

The EndoBarrier trials will run for 24 months with 160 participants and experts at Imperial College Healthcare NHS Trust and Southampton General Hospital will compare EndoBarrier with standard medical therapy for the management of obese people with type 2 diabetes.

Pilot trials have already been performed on adult patients at Southampton General Hospital and two other NHS sites in 2011, results of which show a drop in blood glucose levels within weeks of receiving the implant meaning that patients would require less diabetes medication. Further, patients also achieved significant weight loss similar to that seen following gastric band surgery.

Professor Julian Teare, a consultant gastroenterologist and study lead based at Imperial College London, said that though previous trials have suggested that EndoBarrier therapy is a safe and effective treatment option for type 2 diabetes, the latest study should provide definitive evidence to help guide treatment decisions.

“The use of a lower cost and less invasive alternative to bypass surgery may mean we can treat thousands more people living with type 2 diabetes every year.”

Mr James Byrne, a consultant surgeon and co-lead based at Southampton General, added: “We know weight loss surgery is currently the most effective and longest-lasting treatment option for type 2 diabetes.

“However, it is not the right approach for everyone and will not significantly impact the epidemic of type 2 diabetes we see in the UK.

“Other strategies for this condition are urgently required and our research will confirm whether or not EndoBarrier therapy can help to deliver and, more importantly, sustain improvements in diabetes control.”

In a clinical study in 2012, a team led by Mr Byrne and Dr Nikki Davis, a consultant paediatric endocrinologist at Southampton General Hospital, became the first in the world to treat a teenager with type 2 diabetes using the EndoBarrier device.