Endobarrier (EB) in Diabetes/Prediabetes with Obstructive Sleep Apnea (OSA) Study-Maintenance of Improvement after EB Removal

EB, a 60cm endoscopically implanted proximal intestinal liner is implanted for up to one year and then removed. We assessed Apnoea Hypopnoea Index (AHI), weight and HbA1c before and during EB treatment and following its removal in the 10 patients with moderate OSA requiring continuous positive airway pressure ventilation (CPAP) {80% female, 6/10 (60%) type 2 diabetes, 4/10 (40%) prediabetes, mean ± SD age 53.5±10.3 years, BMI 38.01±2.9 kg/m2} who have attended at least on follow-up after removal. During EB implant, mean ± SD HbA1c fell by 1.2±1.8% from 7.7 ± 1.7 to 6.6 ± 1.1% (p=0.069), weight by 11.1±4.1 kg from 104.9± 14.6 to 93.8±14.7 kg (p<0.001). Prior to EB, all patients had AHI in the National Institute for Health and Care Excellence (NICE) moderate OSA range (15-29.9 events/hour). During EB treatment, AHI of all patients fell below 15 events/hour, such that they no longer required CPAP, according to NICE guidelines. At follow-up at median (range) 9.65 (3-17.6) months after EB removal latest AHI was below 15 in all patients such that they remained off CPAP. Improvements in other metabolic parameters were also sustained (Table). These results confirm previously demonstrated metabolic improvements from EB in diabesity and demonstrate major benefit in the moderate OSA co-morbidity, allowing patients to discontinue CPAP with maintenance of improvement at follow-up. Disclosure M. Yadagiri: None. F.Y. Kinney: None. N. Ashman: None. E.S. Sharratt: None. C. Greenwood: None. J. Adams: None. M.C. Wyres: None. M.H. Lang: None. J. Bleasdale: None. E. Fogden: None. M. Anderson: None. C. Walton: Advisory Panel; Spouse/Partner; Celgene Corporation. Speaker's Bureau; Spouse/Partner; Leo Pharma, Novartis Pharmaceuticals Corporation. M.A. Greenstone: None. R.E. Ryder: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Bioquest. Funding Association of British Clinical Diabetologists