The no-surgery ‘gastric band’ to beat diabetes

It could help tackle obesity too and save NHS millions

A SIMPLE plastic tube could revolutionise the way the NHS treats diabetes.

The fake intestine lining may provide the benefits of a gastric bypass without the expensive surgery.

Doctors at Imperial College London who have begun a £1.6million trial of the EndoBarrier say the device, which could also combat many problems associated with obesity, could be in use within four years and save the NHS millions.

Britain has the second highest rates of obesity in Europe and the condition costs the economy up to £16 billion a year.

Rates of type 2 diabetes, the form of the condition fuelled by obesity, are soaring and the illness eats up a tenth of the NHS’s budget.

It also leads to disabling and life-threatening complications including heart attacks and strokes, blindness and circulatory problems that can lead to amputations.

Trial co-leader Professor Julian Teare said: ‘Obesity is a modern pandemic. There is an urgent need for effective and safe non-surgical treatments for the epidemic of obesity and type 2 diabetes.’

The EndoBarrier is a sock-sized tube constructed from a Teflon-like material.

It is inserted down the throat and through the stomach to the small intestine.

Once there, it mimics the effects of gastric bypass surgery by blocking food from being digested.

A gastric bypass is seen as the most effective way to lose weight, with most patients shedding around two-thirds of their excess weight.

It also leads to dramatic improvements in diabetes patients, with many able to stop taking tablets.

However, there are long waiting lists for gastric bypasses, which require major surgery and cost up to £15,000. Some 2.6million Britons qualify for weight loss surgery but just 6,000 operations are carried out a year.

It is hoped the EndoBarrier, which is made by a US firm, will have a similar effect to a gastric bypass – in which the stomach is made smaller and a section of the intestine put out of action – without the need for surgery.

The new device is inserted in under an hour and patients can go home two hours later.

The two-foot tube reduces the amount of food digested and fools patients into feeling full, meaning most shed a quarter of their excess weight in three months.

Diabetes symptoms improve quickly after a gastric bypass and the EndoBarrier has a similar effect, trials suggest.

It is thought that tinkering with the digestion raises levels of a substance called GLP, which helps to regulate the production and processing of insulin. Insulin, which helps the body process glucose, stops working properly in patients with diabetes.

The EndoBarrier also somehow affects tastebuds, making patients prefer savoury to sweet foods.

It has to be removed after a year, but it is hoped that the changes to the metabolism will be permanent – meaning it could provide a long-term cure for diabetes.

The latest trial is designed to be big enough and detailed enough to determine whether the device is suitable for widespread use on the NHS.

Some 120 obese men and women with type 2 diabetes will be treated in London and Southampton in studies funded by the NHS’s research arm, the National Institute for Health Research, and the Medical Research Council.

Half of the patients will have an EndoBarrier implanted, while the rest will be be given obesity drugs and treated by a dietician.

After a year, the health of the two groups will be compared and more testing will be done a year later to see if the EndoBarrier’s effects have persisted after removal. The first patients have already been treated but more volunteers are needed.

Researcher Dr Aruchuna Mohanaruban, of St Mary’s hospital in West London, said that if the trial is a success, the EndoBarrier could be in widespread use by 2020.

He added: ‘Diabetes and obesity are probably the two biggest epidemics we are facing in the UK.

‘Gastric bypass is one of the most effective treatments for diabetes, with 60 to 70 per cent of patients cured.

‘But not everyone wants to have surgery, it is not without risks and waiting lists are long. This could potentially be an alternative. The EndoBarrier could be a powerful weapon in the fight against obesity.’

Professor David Haslam, chairman of the National Obesity Forum, said: ‘It’s very promising but we have to wait for the trial results.’

But Mike Lean, a diabetes expert and professor of human nutrition at Glasgow University, described it as a ‘veterinary approach’ that ‘cannot have long-term benefits’.

He said that at up to £8,000 a procedure, the EndoBarrier is ‘fantastically expensive’.

Dr Emily Burns, of the charity Diabetes UK, said: ‘It is important to remember that

‘A powerful weapon in fight’

while weight loss surgery for type 2 diabetes is an important treatment option, it should not be seen as a way to fix the type 2 and the obesity epidemic on its own.’

She added: ‘We need more measures to prevent people from becoming overweight and obese.’