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Association of British
Clinical Diabetologists |
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ABCD
Endobarrier Studies - REVISE-Diabesity |
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Advice for Clinicians who might have patients for the study |
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Many thanks for your interest in the
study.
Recruitment has closed, but if
you have a patient that you feel may benefit from Endobarrier, there is:
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an NHS
service for Endobarrier active at City Hospital, Birmingham*
Please send referral to Dr Bob Ryder,
Consultant, City Hospital, Birmingham, B18
7QH.
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a new ABCD
endobarrier research study for patients with
type 2 diabetes, obesity and obstructive
sleep apneoa at City Hospital Birmingham -
please email
mahender.yadagiri@nhs.net
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further
endobarrier / device trials on-going
or planned in London - please email
pya.sengupta@nhs.net
*If you want your patient to be
considered for NHS endobarrier in Birmingham, please provide
a referral letter from GP to confirm:
- type 2 diabetesmellitus,
HbA1c>7.5% / >58mmol/mol
- obesity BMI >35kg/m2 or >30kg/m2
with co-morbidities/South Asian origin
- they have tried GLP-1 receptor
agonist therapy in the past with limited success or
intolerance
- special circumstance - eg good glycaemic control but at
cost of high BMI maintained by high insulin dose
nb - consider whether they can attend Birmingham City
Hospital every 3-months for 2 years and look through
'exclusions' on the
"What is the REVISE-Diabesity study? page"
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The SELECTION CRITERIA are:
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Inclusion criteria (these should all apply)
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Diabetes Mellitus
type 2 with latest HbA1c ≥7.5%
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Obesity with
latest BMI ≥35 Kg/m2 (≥30 Kg/m2 for patients of South Asian
origin)
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Liraglutide
treatment – for at least 6 months, either now or
previously*
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Stable
weight and HbA1c in preceding 3 months
(<3 Kg reduction in weight and <0.3%
reduction in HbA1c) i.e. if the patient’s weight or HbA1c is
rising or falling at a rate slower than described, they meet
this aspect of the inclusion criteria.
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Exclusion criteria (none of these should apply) |
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<18 years of
age
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abnormal
intestinal anatomy e.g. previous surgery, Crohn’s,
ulcerative colitis
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contraindication to oesophago-gastroduodenoscopy
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previous
bariatric surgery or bowel surgery
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active
infection
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anticoagulation therapy which cannot be discontinued/
coagulopathy INR >1.3
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eGFR <30
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known portal
hypertension
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previous
pancreatitis or amylase > 3 times the upper limit of normal
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uncontrolled
cardiovascular disease
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lactating or
pregnant females
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patients
taking aspirin* in whom it should continue (e.g. active ischaemic heart disease or cerebrovascular disease)
*(This is subject to change)
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excessive
anaesthetic risk as identified by the anaesthetist or
investigator (e.g. uncontrolled obstructive sleep apnoea)
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HOW TO REFER
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If you are unsure if your patient
meets the criteria and wish to discuss things further,
please email
revise.diabesity@nhs.net – with information that you are
a doctor or nurse, with your contact details, your
centre and which of London, Birmingham or Glasgow is
nearest.
A few things to think about before referral:
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If your patient lives a
significant distance away from their local REVISE-Diabesity
study centre (City Hospital, Birmingham; King’s College
Hospital, London; Glasgow Royal Infirmary), this study
may not be suitable for them
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Please check that the
patient is happy for you to pass on their contact
details to us before referring. We are then able to
provide all of the necessary information to them via:
- Written information sheets
- Group information sessions/ Individual information
sessions if preferred which includes a presentation,
videos, model demonstration and question and answer
sessions
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Please use nhs.net email
addresses if sending any patient identifiable
information or contact information.
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We are able to supply patient
information sheets and a poster for your surgery/ clinic so
that patients can self-refer if they wish. |
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Working to support high quality diabetes care in the UK |
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