Plastic tube in your gut that reverses diabetes
PLaCing a plastic sheath in the gut triggers weight loss and could reverse diabetes. The treatment has a similar effect to a gastric band but avoids the need for risky and expensive surgery. instead, a 2ft (60cm) sheath known as the EndoBarrier is positioned at the top of the small intestine using an endoscope — a thin, flexible tube inserted via the mouth — while the patient is under general anaesthetic or sedation.
results from a recent study in obese type 2 diabetes patients fitted with the device showed they lost an average of more than 2st in a year and had better-controlled blood sugar levels. Some even stopped needing insulin injections.
Britain has one of the highest obesity rates in Europe. Diabetes can cause serious complications including heart attacks, strokes, blindness, and limb amputations. The majority of people with diabetes in the Uk are type 2, which is caused by an unhealthy diet and lifestyle.
The EndoBarrier is fixed in place by a wire frame. The tube lines the first 60cm of the small intestine, allowing food to pass through without being absorbed by the digestive system.
Doctors are still unsure why, but this stimulates a feeling of fullness that means patients consume less, leading to weight loss. One theory is the body senses there is something in the small intestine so does not trigger the hormonal response to feel hungry.
ArECEnT pilot trial at City hospital, in Birmingham, involving 25 patients fitted with the EndoBarrier found that they lost an average of 16.3kg (2st 8lb) a year, according to data presented at the Diabetes Uk Professional Conference.
results showed most patients needed less insulin, while a quarter saw a reversal of their diabetes and no longer needed it at all.
They also experienced ‘dramatic’ drops in blood pressure and liver fat levels, both of which are linked to an increased risk of complica- tions such as heart disease. another ten NHS hospitals around the Uk are now planning to trial the treatment within the next year, although specific details haven’t been announced.
it could also potentially save the NHS millions: gastric bypass surgery costs around £15,000 per patient, while EndoBarrier costs around £4,800. The device must be checked by endoscopy every three months to ensure it’s in the correct position. it is removed after a year and early follow-up data showed that, a year after removal, most patients had kept the weight off.
Once the device is fitted, patients can only consume liquids for the first week and pureed food for the second. Then they can eat anything, but the idea is they eat less so don’t gain weight.
Dr robert ryder, a diabetes consultant and chief investigator of the study, said the treatment is ‘miraculous’. ‘To have something that removes the need for insulin is a godsend. They come to my clinic bouncing with happiness.’
Commenting on the research, Diabetes Uk’s Dr Elizabeth robertson says: ‘The results of this trial are promising, but long-term, large-scale studies are needed to understand the true impact of EndoBarrier on the management of type 2 diabetes.’
MEANWHILE scientists are closer to finding out which genes predispose people to developing type 2 diabetes. imperial College London and University College London researchers studied genetic data from 5,800 patients and 9,691 healthy people.
They found 111 loci — positions of genes on a chromosome — linked to the condition. Once scientists establish which genes predispose people to it, they may be able to develop tests to check who is at risk, so doctors could intervene before it develops.