Outcomes of Endoscopic Bariatric Therapies in Diabetic Patients

Endoscopic bariatric therapies (EBTs) have been utilized for the treatment of obesity, but there has been limited data assessing their role in the treatment of diabetes.

A recent study presented at the annual American College of Gastroenterology (ACG) 2020 conference found that this procedure led to improved diabetes and weight loss parameters. The positive outcomes of EBTs in assessed diabetes patients were particularly noted for 3-12 months of use.

Additionally, the study determined that small bowel EBTs were more effective than gastric EBTs, which the investigators suggested might be due to different mechanisms of action.

The team, led by Benjamin Noor, MD, Resident at Ronald Reagan UCLA Medical Center, searched through MEDLINE, Embase, and Cochrane for randomized clinical trials and observational studies of EBTs.

Thus, included in their analysis were 1053 citations, 79 studies, and 7692 subjects.

Primary analyses included the pooled mean difference in baseline and final values in weight loss (percentage total weight loss, percentage excess weight loss, and BMI change from baseline) and glycemic control (fasting glucose, HbA1c) parameters.

Secondary analyses included changes in gut hormones measured by Hedges’ g. Specifically, they assessed the changes in ghrelin, glucagon-like peptide 1, peptide YY, and glucose-dependent insulinotropic peptide.

The results showed that EBT use for 3-12 months was associated with significant improvement in diabetes outcomes and weight loss indices in comparison with baseline or control groups. Although small bowel EBTs and gastric EBTs led to similar weight loss outcomes, greater improvements in diabetic parameters was associated with small bowel EBTs.

Furthermore, the authors noted that improvements in diabetes were associated with weight loss for gastric EBTs and an increase in postprandial glucagon-like peptide 1 and peptide YY for small bowel EBT.

In an interview with HCPLive®, Noor provided further insight into these findings as well as the implications of them for a diabetic patient population.