Changes in glycemic control and body weight after explantation of the duodenal-jejunal bypass liner

详细信息    查看全文

• 作者：Bark Betzel ; MD¹ ; ; Parviez Koehestanie ; MD¹ ; Jens Homan ; MD¹ ; Edo O. Aarts ; MD ; PhD¹ ; Ignace M.C. Janssen ; MD¹ ; Hans de Boer ; MD ; PhD² ; Peter J. Wahab ; MD ; PhD³ ; Marcel J.M. Groenen ; MD ; PhD³ ; Frits J. Berends ; MD ; PhD¹
• 关键词：BP ; blood pressure ; DJBL ; duodenal-jejunal bypass liner ; FPG ; fasting plasma glucose ; GLP-1 ; glucagon-like peptide-1 ; HbA1c ; glycosylated hemoglobin A1c ; T2DM ; type 2 diabetes mellitus ; TBWL ; total body weight loss
• 刊名：Gastrointestinal Endoscopy
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：85
• 期：2
• 页码：409-415
• 全文大小：418 K
• 卷排序：85

文摘

The duodenal-jejunal bypass liner (DJBL) is an endoscopic device that induces weight loss and improves glycemic control in patients with type 2 diabetes mellitus (T2DM). The aim of the current study was to assess the effects of DJBL explantation on glycemic control and body weight.MethodsThis prospective, observational study included only patients with T2DM who had the DJBL implanted for at least 6 months and had a follow-up of at least 12 months after explantation. The primary endpoints were changes in glycosylated hemoglobin A1c (HbA1c) and body weight during the 12 months after explantation. Secondary endpoints were changes in fasting plasma glucose, blood pressure, and plasma lipid levels.ResultsIn total, 59 patients completed the 12-month follow-up after explantation. During this period body weight increased by 5.6 (standard deviation, 6.4) kg (P < .001) and HbA1c rose from 65 (SD 17) to 70 (SD 20) mmol/mol (P < .001). However, body weight remained 8.0 (SD 8.6) kg (P < .001) lower than before implantation, that is, corresponding to a net total body weight loss of 7.4% (SD 7.6) (P < .001). Although HbA1c was significantly higher 12 months after explantation compared with baseline and the mean daily dose of insulin used was comparable, the number of patients on insulin remained significantly lower than before implantation.ConclusionsExplantation of the DJBL is associated with weight gain and worsening of glycemic control, although some beneficial effects remained detectable 12 months after explantation. A change in strategy is needed to preserve the beneficial effects of DJBL treatment. (Clinical trial registration number: 746∖100111.)