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Obesity is a serious risk factor for diabetes. Bariatric surgery is often used to treat severe obesity. EndoBarrier is a new device that can substitute this surgery. When placed in intestine, it helps to achieve weight loss and improvement in diabetes.

What is an EndoBarrier and what it has to do with diabetes medication? This is a question that would rise in the minds of people who have not heard about this long, flexible, tube-like device lately being used in the treatment of obese and diabetic patients. This device is placed in the small intestine to prevent the mixing of food particles with digestive enzymes. Very soon EndoBarrier is expected to substitute the bariatric surgery, the weight reduction procedure that is currently relied upon by doctors to treat morbid or severe obesity.

Obesity and diabetes are closely linked

Obesity, the excessive accumulation of fat in the body, is a risk to health in many ways.

Obesity is associated with various co-morbidities like diabetes, heart diseases and malignancies like colon cancer.

These diseases are the major causes of deaths worldwide and hence prevention and treatment of obesity has an important role in preventing these conditions.

Obese people are at a significantly higher risk of developing type-2 diabetes mellitus compared to normal population. While type-1 diabetes mellitus is a consequence of insufficient insulin production, type-2 diabetes occurs due to the body’s resistance to insulin. Obesity plays its part in the development of insulin resistance. Endocrine, inflammatory and neuronal pathways are proposed to be involved in this obesity-induced insulin resistance. Treatment of obesity aims primary to address this issue and its consequence – the high blood sugar level.

Bariatric surgery controls obesity and keep in check diabetes mellitus

Controlling obesity is not as easy as it is said. Weight reduction measures like diet control, physical exercise, avoiding sedentary life style etc., need strict adherence while anti-obesity drugs do not always provide much expected long term benefits. In serious cases, the best method to achieve the desirable effects in weight reduction is by surgery.

Studies show encouraging results regarding bariatric surgery. This procedure involves surgical reduction of the size of stomach and removal of upper parts of small intestine. In addition to the weight reduction, improvement in type-2 diabetes is also seen in obese diabetic patients who have undergone this surgery.

An interesting fact is that patients show marked remission in diabetes even before achieving the weight loss.

Apart from this, there are strong evidences showing improvement or complete remission of the other co-morbid conditions like hypertension and high cholesterol level that are associated with obesity. In fact, studies show that bariatric surgery has a primary independent effect in controlling type-2 diabetes mellitus rather than the effect secondary to weight reduction. These findings support the importance of performing this surgery in morbidly obese patients especially those with diabetes.

EndoBarrier is less invasive compared to bariatric surgery

Though various studies show evidence that bariatric surgery is a better solution when compared to medical treatments for morbid obesity, the procedure is not free of disadvantages. Being a type of bypass surgery, it has side effects like leakage from the site of anastomosis (connection between the two cut-ends of gastrointestinal tract), bleeding, infection, malabsorption (especially iron deficiency) and many others. A small number of people may also need additional surgery.

Hence appears the necessity for a procedure that can overcome these disadvantages of bariatric surgery and promise to offer advantages like weight loss, diabetes control and heart disease prevention in a less invasive manner.

Continue reading after recommendations

  • Buchwald, H. et al. (2004) Bariatric surgery: A systematic review and meta-analysis. JAMA 292(14), p.1724-1737
  • Rubino, F. & Gagner, M. (2002) Potential of surgery for curing Type-2 Diabetes Mellitus. Annals of Surgery 236(5), p. 554-559
  • Gloy, V. L. et al. (2013) Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. British Medical Journal 347(10), f5934
  • de Moura, E. G. et al. (2012) Metabolic improvements in obese type 2 diabetes subjects implanted for 1 year with an endoscopically deployed duodenal-jejunal bypass liner. Diabetes Technology & Therapeutics 14(2), p. 183-189
  • Rohde, U. et al. (2013) Effect of the EndoBarrier Gastrointestinal Liner on obesity and type 2 diabetes: protocol for systematic review and meta-analysis of clinical studies. BMJ Open 3(9), E003417
  • de Jonge, C. et al. (2013) Endoscopic Duodenal - jejunal bypass liner rapidly improves type 2 diabetes. Obesity surgery 23 (9), p. 1354-1360.
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