Doctors at Southampton’s university hospitals are the first in the world to fit a teenager with a revolutionary implant that could help to tackle the growing childhood type 2 diabetes crisis.
A team led by Dr Nikki Davis, a consultant paediatric endocrinologist, and James Byrne, a consultant surgeon, at Southampton General Hospital fitted 17-year-old sufferer Victoria Parr, of Lymington, Hants, with the EndoBarrier – a non-surgical device placed in the upper intestine via the mouth that reduces the need for medication to treat the condition and aids weight loss.
Type 2 diabetes, which affects more than 2.5m people in the UK, can run in families, but is also associated with an inactive lifestyle, being overweight and poor diet, and is increasingly common among children and young adults.
The condition, which develops when a person becomes resistant to insulin, a hormone released by the pancreas to drive glucose (sugar) from the blood stream into muscles and organs to fuel the body, increases the risk of heart and kidney failure in the long-term, and can lead to stroke, blindness and nerve damage.
The EndoBarrier, a small plastic sleeve which stays in the body for up to 12 months, acts as a barrier to prevent food being absorbed and ensures it bypasses a section of the upper intestine, allowing less time for digestion and improving the resistance to insulin.
"This is potentially a major addition to the treatments currently available for severe type 2 diabetes and obesity in teenagers, and could help to address the progression of the condition and the early development of complications in an increasing number of cases among children and adolescents," explained Dr Davis.
"Victoria’s is a particularly severe case in that she was unable to tolerate a number of different medications for type 2 diabetes and has rapidly progressive diabetes despite trying very hard with diet and exercise. This meant she had to rely on insulin injections to control her diabetes, which we know can prevent weight loss.”
She added: “The EndoBarrier is easy and quick to insert and is a reversible procedure with a low risk of complications and, therefore, could be a safe way to dramatically improve the treatment of severe type 2 diabetes and obesity in young people, though it is still vital that young people on weight reduction programmes receive full support from the weight management team before, during and after weight loss procedures in order to ensure long-term success."
The procedure, which was trialled on adult patients by Mr Byrne and his colleague Jamie Kelly in a pilot NHS study at University Hospital Southampton NHS Foundation Trust last year in collaboration with two other UK hospitals, is performed under a short general anaesthetic and sees patients return home within two to three hours.
Results of their study showed a drop in blood glucose levels within weeks of receiving the implant – reducing the need for medication – while patients also achieved significant weight loss in line with that seen following invasive gastric band surgery.
Mr Byrne, who is also a senior lecturer at the University of Southampton, explained: "This is a landmark moment for young people who suffer from type 2 diabetes and weight problems as, through a completely reversible procedure, we will be able to kick start the weight loss process and immediately cut the amount of medication Victoria needs without a higher risk, permanent surgical intervention.
"Over the course of a year we expect Victoria to reset her metabolic clock and she will be given support throughout to sustain the health benefits once the device is removed, which should then help her to maintain the reduced need for medication and, possibly, eliminate it altogether."
Posted on Wednesday 29 February 2012