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British study investigates EndoBarrier plus Victoza treatment for type 2 diabetes

Combining the EndoBarrier intestinal device and the diabetes drug Victoza (liraglutide) helps obese patients with type 2 diabetes lose more weight and experience better glycemic control than using either the device or the drug alone, a study finds.
The study was led by Piya Sen Gupta, MBBS, BMedSci, MRCP, research fellow at King’s College Hospital London and City Hospital Birmingham, United Kingdom.
Sen Gupta and colleagues recruited 70 obese patients with poorly controlled type 2 diabetes. On average, the patients were in their early- to mid-fifties and had a body mass index (BMI) of roughly 41 kg/m2.
All the patients were taking liraglutide at baseline. This is a GLP-1 analogue for the treatment of type 2 diabetes, which helps to lower blood glucose levels and promote weight loss.
Patients were randomised to one of three groups. The first group (24 participants) received liraglutide and EndoBarrier; the second group received only an EndoBarrier; and the third group received only liraglutide.
The EndoBarrier is worn inside of the body. It is a thi, plastic sleeve which lines the first 60cm of the small intestine, causing food to be absorbed further down in the intestine. This can help with weight loss and reduce blood sugar levels in patients with type 2 diabetes.
All patients were given the same diet and dietary information for the first two weeks of the study. The, the EndoBarrier group received the implant and were assessed every three months for up to one year.
Patients in the EndoBarrier-plus-liraglutide group experienced a 2.1 per cent reduction in HbA1c, which was better than the reduction in the EndoBarrier-only group (1.5 per cent) and the liraglutide-only group (1.2 per cent).
Furthermore, the EndoBarrier-plus-liraglutide and EndoBarrier-only groups lost more weight than the liraglutide-only group (12.8 kg, 12.5 kg and 4.0 kg, respectively). EndoBarrier treatment was found to be safe and well tolerated in both groups.
Sen Gupta said: “This is the first study in which the combination of a GLP-1 receptor agonist drug and the EndoBarrier intestinal device has been used to successfully treat diabetes and obesity. The combination seems to result in the best improvements in both.
“The EndoBarrier is less invasive than surgery, achieves a similar level of bypass, and can be inserted as a simple quick outpatient endoscopic procedure that patients are likely to find more acceptable. They have one year in which to change their eating behaviour, and the EndoBarrier helps to do this.
“This is an exciting area of research. Surgical options such as gastric bypass of a large area of stomach and upper intestine are often successful in improving diabetes and producing weight loss, but they are fairly radical and irreversible options, and are not widely available. Less invasive options that produce similar effects would be ideal, particularly if they result in sustained eating behaviour modification.”
The one-year results of this two-year study were presented on Saturday April 2 at ENDO 2016, the annual meeting of the Endocrine Society in Boston.

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