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The EndoBarrier

Discussion in 'Book and Product Reviews' started by candyrel, Oct 1, 2008.

  1. candyrel

    candyrel Type 2 · Well-Known Member

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    This was copied and pasted from an article in yesterdays Daily Mail


    A 'bin liner' that sits inside the gut and stops it absorbing calories from food could be a radical new treatment for diabetes.
    The 2ft-long plastic sheath acts as a barrier between food and the lining of the small intestine.
    This stops enzymes in the intestine wall mopping up fats, sugar and nutrients from food as it passes through.

    bypass surgery for those needing to shed large amounts of weight.

    Now doctors have discovered it can also have a dramatic effect on blood sugar levels.
    In a small trial involving 12 patients, the 'bin liner' therapy was shown to be as good as existing prescription drugs at lowering blood sugar levels.

    And it took just six months to get them down to a 'healthy' level - less than half the time it can take for drugs to have the same effect.
    Diabetes affects at least two million people in Britain. The condition develops when the pancreas stops producing insulin altogether or the body becomes resistant to its effect.

    The body needs insulin to help muscle cells absorb glucose from our diets and use it as fuel for energy.
    Without the right levels of insulin, glucose levels can build up - a condition called hyperglycaemia. This can cause long-term irreversible damage to the kidneys, eyes, nerves, heart and major arteries.
    Type 1 diabetes tends to affect young people, who often end up needing daily insulin jabs every day for the rest of their lives.

    Type 2 usually affects people from middle-age onwards and can often be controlled through diet, exercise and tablets to lower blood sugar.

    Some experts fear Britain faces an epidemic of type 2 diabetes due to rising obesity levels. It's thought people with type 2 could benefit from the sheath.
    One of the most recent - and successful - ways of treating type 2 diabetes is gastric bypass surgery.
    In this procedure, surgeons cut the oesophagus, or food pipe, where it enters the small intestine and reattach it about 2ft further down.
    This means food spends less time passing slowly through the narrow small intestine and instead passes straight into the large intestine.
    As a result, the gut has less opportunity to soak up calories.
    Studies show that obese patients with type 2 diabetes experience a sharp drop in glucose levels after a gastric bypass.
    But it is a major operation which involves a long recovery period. The EndoBarrier, developed by a U.S. firm called GI Dynamics, could be a cheap and easy alternative.
    The patient is given a general anaesthetic and the 2ft plastic liner is inserted through the mouth using a thin tube called a catheter.

    Once it is in position, it is gradually unravelled until it lines most of the small intestine.
    The surgeon then secures it in place using tiny titanium anchors that hook into soft tissue at the entrance to the intestine. The whole procedure takes around 30 minutes.
    In the latest study, 12 patients with type 2 diabetes were fitted with the plastic liner.
    The results, presented at a diabetes conference in New York, showed that after three months the patients' glucose levels dropped so much that some patients were able to stop taking medication completely.
    Dr Christopher Sorli, who tested the Endo-Barrier at Billings Clinic in Montana, U.S., said: 'It can take up to two years on aggressive therapies to see the kind of drop that we are seeing in just 30 weeks with the Endo-Barrier.'
     
  2. hanadr

    hanadr · Expert

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    I can't see why it needs to take 2 years to get BGs down in the first place. Obviously this bin-bag is simulating a low carb diet. In their own country Bernstein and Jovanovic are ignored.
    I can see the bin bag failing with patients who are going to keep eating high carb.
     
  3. Dennis

    Dennis Type 2 · Well-Known Member

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    I think Hana and I are on similar lines here. Why go to all this trouble so that you can continue to eat junk, when it is far easier to just stop consuming junk?

    One other point - if it stops the absorbtion of glucose and calories, then it must also stop the absorbtion of everything else, like any minerals and vitamins in the food, and the incretins through which the stomach sends messages to the pancreas to start producing insulin is response to food.
     
  4. DiabeticGeek

    DiabeticGeek · Well-Known Member

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    This sort of drastic intervention always seems to be rather like sticking your finger in a dyke. It may work, to a point, but it is avoiding the real issue rather than confronting it. It is like gastric bypass for weight loss - although it is extremely effective in the short term, in the long term many people who have this operation develop whole new ways of overeating.

    Incidentally, this is a completely different issue from the observation that gastric bypass surgery sometimes has dramatic effects upon diabetes. This is quite well know, but the reasons for it are not at all well understood. It is almost certainly not simply the result of reducing the absorption of sugar, it is probably something more complex than that. Probably some hormone produced by stomach tissue (leptin is a likely candidate for this) has a profound effect upon glucose metabolism.

    Coming back to the "EndoBarrier" - adopting a low carb lifestyle is likely to have much the same effect, but be far more sustainable.
     
  5. hanadr

    hanadr · Expert

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    And safer and cheaper! You don't need any anaesthesia or sedation for low carb
     
  6. Trim

    Trim · Member

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    Hi as a newbie to this forum I might be thought of as rude (sorry) but I can't stop myself from protesting the previous posts as I strongly disagree with them, the world epidemic of obesity and type two diabetes is increasing at an alarming rate, despite various low carb diets etc. The EndoBarrier is such a good idea that even weak willed plonkers like me could benefit from it for at least a few years and if the British National Health Service really got behind it, the costs would work out lower than all the pills, operations and hospital stays that the present and future epidemic would come to. The 'few years' of extra health would encourage me at least to be more positive in my attitude.
     
  7. saz1

    saz1 · Well-Known Member

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    But dear Trim, you don't necessarily have to think about a few more years of health, if you have a good control, you can have unlimited good years ahead of you. There is no long term studies done about this treatment and it could be detrimental to mineral and vitamin levels as well as other nutritional points. If it detaches, blockages would form and you might just have a foreign body reaction... I am also a weak willed plonker, very overweight too, and still will not go to the extent of these kind of treatments.
     
  8. Trim

    Trim · Member

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    No it doesn't the small intestine appears to have different areas to absorb or ingest nutriments, minerals and vitamins, it seems the first 60 cms likes the stuff which causes a big spike in glucose, a small amount of malabsorbtion if it occurs is a lot easier to deal with then the complications of obesity and diabetes.

    In my opinion this forum should be backing the Endobarrier bigtime and campaigning to get medical practitioners on board and trained up. Diet and willpower may help the 'saints'
    but the 'sinners' need things like the Endobarrier.
     
  9. Dennis

    Dennis Type 2 · Well-Known Member

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    Trim,

    This forum doesn't "back" anything and nor is it intended to. It is a means whereby people can express their experiences of diabetes and their opinions. It is not a political soapbox.

    By all means express your own opinion but please do not criticise others for expressing theirs.
     
  10. Trinkwasser

    Trinkwasser · Well-Known Member

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    Seems to be that these "mechanical" solutions are interfering with a biochemical signallling system and a longer term approach would be to further research non-surgical methods of interfering with the same system. For some of us it;s as simple as not eating toxic quantities of carbs but for others it's more complicated.
     
  11. Trim

    Trim · Member

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    Dennis
    Maybe it should have a political thread or even an ideas thread. For a start encourage government to give cash or prizes for people to lose weight, stop smoking or control their blood sugar. Even a MBE or knighthood for an average Joe Bloggs who does his bit to help the NHS to save money and improve the nation's health. Making it really 'sexy' to stop being a couch potato. Being on TV ( Who wants to be A millionaire?) having tickets for shows and sport venues for friends and family. Unfortunately unlike you, 95% of dieters fail and Doctors and dietitians are of limited use the 'endobarrier' (I so wish I could get one now instead of ten years) seems to be a blessing for those who can't get past the starvation mode stop who find it easier to stick to a diet at the beginning, when they are consistently losing weight, until their body adapts and has a big increase and they give up. Three months to a year of losing weight with the Endobarrier and say a low carb diet should be enough to reduce 'cravings' as well as diabetes and making one slimmer. Even if it is necessary to have the endobarrier taken out after that time the patient would have learnt new eating habits.

    Who exactly did I have a go at?
     
  12. catherinecherub

    catherinecherub · Guest

    Hi Trim,I can understand your frustration at not being able to get this surgical intervention. It would solve a lot of people's problems.
    What is it that you find so difficult when trying to loose weight? I know that dieting produces results but does not happen overnight. Perhaps diet is the wrong word, how about adopting a new eating plan. Nobody on the forum who is or was overweight finds it easy and there are days when we could all scream about it.
    Give yourself a month, following some of the advice on here and see what the results are. Keep a food diary so that you know what you eat and then come back and tell us how you are getting on.
    I would be very surprised if you cannot see any good results.
    Worth a try?
    Regards, Catherine.
     
  13. Trim

    Trim · Member

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    Thanks for your post CC. For the past thirty years I have trying all sorts of 'eating plans' (diets) I did for a while have some success with the HAY diet and Atkins but for some unknown reason despite losing several stones it eventually crept back on plus extra. Plus eating a high protein diet gets very expensive. A so called "surgical intervention" sounds like a lot of cutting and high risk which the endobarrier doesn't, although some patients have a general anesthetic. All it involves is an endoscope going through the stomach into the top of the small intestine where a 20inch sheath is deployed and kept in place by so called memory wire (the most expensive part) at the top of the intestine. All food from the stomach passes through this sheath but can't be ingested for the important first 20inches this very successful surgical intervention is still rare and expensive(much less so then standard ops) but mass take up would save the NHS a heck of a lot of money as its price would come crashing down. :D One of the reason I am so excited by this is I sort of thought of it first, my sister has a lot of her intestine removed because of chronns disease and of course is extremely thin not wanting my intestine removed I came up with The idea of a barrier but all the Doctors I suggested it to fifteen years ago thought it was a daft idea. I am so glad the Endobarrier has proved them wrong. :lol:
     
  14. catherinecherub

    catherinecherub · Guest

    Hi Trim,
    I did read up on the procedure. I don't think it will be made available some time soon so my question to you is what are you going to do in the meantime? Do you have the support of family and friend? This can be a great motivator as we all need praise and encouragement. Some low carbers are doing extremely well using cheaper cuts of meat and shopping around for other proteins, i.e. cheese, eggs and fish . Veggies do not have to be obtained from supermarkets that all price them the same, take advantage of offers, use market stalls or even frozen. Vegetarians are also finding success, perhaps it is not so expensive as you think. Someone could perhaps explain the ratio of protein to a meal as I personally do not follow low carbing but my understanding is that it does not involve upping your intake of protein but reducing your carbs and increasing the fat content. I have found that by reducing my carbs and using low fat ,as in the G.I. method I use, that this is also working. There are variations throughout the forum as to how people are managing to control their weight and diabetes. Some just make a slight reduction in carbs and they are successful.
    Trim, (love the name) I think that by coming to the forum it was not just about the surgery you would like. Other people's experiences can help us all so please, try something that may work for you. Nobody here is bashing your postings, but waiting for something to happen which is beyond your control is not going to help either. Bite the bullet and try. We are all behind you and will encourage you every step of the way.
    Regards, Catherine.
     
  15. epicure_2002

    epicure_2002 Type 2 · Member

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    can anyone tell me where else in europe this procedure is carried out. specifically if you know of any clinic or hospital or surgeon of reference for switzerland. also would be interested in what this procedure would cost. thanks for any help.
     
  16. catherinecherub

    catherinecherub · Guest

    This hospital, in the South of England has done one.
    Might be worth asking there.

    viewtopic.php?f=25&t=27242
     
  17. Riri

    Riri Type 1 · Well-Known Member

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    From the comments by the doctors in southampton and the results this procedure claims to achieve I think it's brilliant that new things like this are being trialled and implemented in the UK. Why wouldnt we want to give T2 diabetics treatment that may actually work instead of ignoring the fact that drugs/diet do not work for everyone in all circumstances. The fact that it's relatively low-risk as well is a big plus. I hope it is offered to more patients if it proves to work.
     
  18. epicure_2002

    epicure_2002 Type 2 · Member

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    i mentioned this procedure to my dr. here in switzerland, where i live. he is an internist and specialises in weight loss procedures and promotes the bypass for obesity and diabetes management. he has never heard of this endobarrier procedure, but said he would look into it. imagine having had this irreversible bypass procedure, only to learn there is another less risky reversible procedure!!
    i've checked out the info on the gi dynamics website and they are setting up centers of excellence across europe.
    they even have reimbursement schemes! they also claim to be developing longer lasting endobarrier sleeves for prolonged use.
     
  19. bgad

    bgad · Newbie

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    I have seen that you can get an Endobarrier privately in a few UK hospitals now. I think in Southampton, London and Manchester. Really a treatment like this needs to be available on the NHS.
     
  20. sweetLea

    sweetLea · Well-Known Member

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    I can see how this procedure could help some people but really I just wish there was more education on nutrition and sustaining weight loss and healthy diet available. Maybe if correct nutrition was taught effectively in schools then there would be less need for these procedures in the first place???
    I'll just get off my soapbox now.......................... :roll:
     
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