జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Six Months Results of the Duodenal-Jejunal Bypass Liner for the Treatment of Obesity and Type 2 Diabetes

Eduardo Guimarães Hourneaux De Moura, Bruno Da Costa Martins, Guilherme Sauniti Lopes, Ivan Roberto Bonotto Orso, Suzana Lopes De Oliveira, Marcio C. Mancini, Manoel Passos Galvão Neto, Marco Aurélio Santo, Paulo Sakai and Ivan Cecconello

Background: The duodenal-jejunal bypass liner (DJBL) is an endoscopic device that excludes the duodenum and initial portion of the jejunum from the contact with the chyme. It has been shown to be effective for weight loss and may improve the control of type 2 diabetes mellitus (T2DM). The objective of this study is to evaluate the efficacy of the DJBL in weight loss and in T2DM control over a 24-week period.

Patients and Methods: Obese (BMI ≥ 35 kg/m²) and T2DM patient candidates for bariatric surgery were prospectively assigned to the implant of the DJBL at an academic endoscopy referral center (São Paulo - Brazil) Results: Twenty-two patients were submitted to the implant procedure, with technical success of 100%. At week 24, mean weight loss was 14 kg (p<0.001). BMI dropped on average 5.4 points and excess weight loss was 22.2%. Fasting glucose (baseline = 171.8 mg/dl; W24 = 141.5 mg/dl) and glycosylated hemoglobin levels (8.8% to 7.3%) were significantly reduced. There was also a reduction in the usage of anti-diabetic medications (except metformin).

Conclusions: The DJBL is an effective weight loss method and also promotes glucose control over a 24-week period. Long-term studies with post-removal follow-up are required to determine its role in the management of type 2 diabetes.