Abstract
ObjectiveThe aim of this research was to study the duodenal-jejunal bypass liner (DJBL) treatment for obesity and type 2 diabetes mellitus (T2DM) in patients after dietary treatment in a cross-over design.BackgroundDJBL treatment has been proven effective for treatment of obesity and T2DM. However, data on safety and efficacy of a 12-month DJBL treatment is limited.MethodsIn 2014, our research group reported on a multicenter randomized clinical trial. Patients were randomized to DJBL or dietary treatment (control group). Twenty-eight patients crossed over after their dietary treatment and received up to 12 months of DJBL treatment. Patient visits were conducted at baseline, during DJBL treatment (1 week, 1–6, 9, 12 months) and 6 months after removal of the liner. Patients underwent a standard physical examination, blood sampling, assessment of adverse events, nutritional and diabetes counseling, and a standardized meal tolerance test.ResultsOf the 28 patients included in this study, 24 patients completed 6 months of treatment. Eighteen patients were extended to 12 months of DJBL treatment; 13 patients completed this treatment period. After 6 months of DJBL treatment, a significant increase in excess weight loss (EWL) and decrease in weight, BMI, HbA1c, fasting glucose, cholesterol, HDL and LDL improved significantly. After 12 months of DJBL treatment, these parameters stabilized.ConclusionsThe DJBL is an effective, minimally invasive treatment option. Even after successful treatment with dietary restrictions, the DJBL is still capable of significantly reducing weight and improving cardiovascular and type 2 diabetes mellitus parameters in obese patients.
Highlights
Worldwide over 600 million people suffer from obesity (BMI ≥ 30 kg/m2) [1, 2]
The obese population is at high risk to develop chronic diseases, such as metabolic disorders, cardiovascular diseases, cancer, and wear and tear of the musculoskeletal organ [5,6,7,8]
Inclusion criteria consisted of a BMI ranging from 30 to 50 kg/m2, type 2 diabetes for less than 10 years, and a glycated hemoglobin A1c (HbA1c) level between 7.5%–10%
Summary
Worldwide over 600 million people suffer from obesity (BMI ≥ 30 kg/m2) [1, 2]. The population of the USA accounts for 13% of this obese population, which is approximately one OBES SURG (2018) 28:1255–1262 third of the country’s population [3]. The obese population is at high risk to develop chronic diseases, such as metabolic disorders (diabetes mellitus, fatty liver disease), cardiovascular diseases, cancer, and wear and tear of the musculoskeletal organ [5,6,7,8]. Surgery has been proven most successful in the treatment of obesity and its comorbidities [10,11,12]. Current surgical techniques are still accompanied by perioperative and postoperative complications. Several endoluminal techniques have been developed with the intent to reduce perioperative and postoperative complications while maintaining treatment success. These techniques provide an alternative treatment option for the growing overweight and obese population (BMI between 25 to 35 kg/m2)
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