{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:01:00Z","timestamp":1789552860163,"version":"build-2803163510"},"reference-count":44,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T00:00:00Z","timestamp":1524182400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Duodenal-jejunal bypass liner (DJBL) is an endoscopic device that may mimic small bowel mechanisms of Roux-en-Y gastric bypass (RYGB). Previous studies have demonstrated the efficacy of DJBL at inducing weight loss. We assessed the effect of DJBL on glycemic control in patients with type 2 diabetes (T2D) with obesity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Data sources included MEDLINE, EMBASE, and Web of Science through 1 July 2017. Included were published studies that assessed DJBL outcomes in obese T2D patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Primary outcomes were change in HbA1c and HOMA of insulin resistance (HOMA-IR). Secondary outcomes were change in weight and gut hormones glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and ghrelin. Seventeen studies were included. At explant, HbA1c decreased by 1.3% [95% CI 1.0, 1.6] and HOMA-IR decreased by 4.6 [2.9, 6.3]. Compared with control subjects, DJBL subjects had greater HbA1c reduction by 0.9% [0.5, 1.3]. Six months after explant, HbA1c remained lower than baseline by 0.9% [0.6, 1.2]. At explant, patients lost 11.3 kg [10.3, 12.2], corresponding to a BMI reduction of 4.1 kg\/m2 [3.4, 4.9], total weight loss of 18.9% [7.2, 30.6], and excess weight loss of 36.9% [29.2, 44.6]. The amount of weight loss remained significant at 1 year postexplantation. After DJBL, GIP decreased, whereas GLP-1, PYY, and ghrelin increased.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>DJBL improves glycemic control and insulin resistance in T2D patients with obesity. DJBL also appears to induce significant weight loss in this population. Additionally, changes in gut hormones suggest mechanisms similar to RYGB. Study limitations included heterogeneity among studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc17-1985","type":"journal-article","created":{"date-parts":[[2018,4,20]],"date-time":"2018-04-20T19:35:32Z","timestamp":1524252932000},"page":"1106-1115","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":119,"title":["Effect of the Duodenal-Jejunal Bypass Liner on Glycemic Control in Patients With Type 2 Diabetes With Obesity: A Meta-analysis With Secondary Analysis on Weight Loss and Hormonal Changes"],"prefix":"10.2337","volume":"41","author":[{"given":"Pichamol","family":"Jirapinyo","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women\u2019s Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea V.","family":"Haas","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, MA"},{"name":"Division of Endocrinology, Diabetes and Hypertension, Brigham and Women\u2019s Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6105-5270","authenticated-orcid":false,"given":"Christopher C.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women\u2019s Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2018,4,12]]},"reference":[{"key":"2022031301185835100_B1","first-page":"1","article-title":"Prevalence of obesity among adults and youth: United States, 2011-2014","volume":"219","author":"Ogden","year":"2015","journal-title":"NCHS Data Brief"},{"key":"2022031301185835100_B2","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.2337\/dc12-2625","article-title":"Economic costs of diabetes in the U.S. in 2012","volume":"36","author":"American Diabetes Association","year":"2013","journal-title":"Diabetes Care"},{"key":"2022031301185835100_B3","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1001\/jama.292.14.1724","article-title":"Bariatric surgery: a systematic review and meta-analysis","volume":"292","author":"Buchwald","year":"2004","journal-title":"JAMA"},{"key":"2022031301185835100_B4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1002\/bjs.7704","article-title":"Effect of the definition of type II diabetes remission in the evaluation of bariatric surgery for metabolic disorders","volume":"99","author":"Pournaras","year":"2012","journal-title":"Br J Surg"},{"key":"2022031301185835100_B5","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1097\/SLA.0b013e3182a5034b","article-title":"Can diabetes be surgically cured? 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