Table 2.
The effects of medical devices on managing obesity and DM.
| Treatment | Mechanism of action (Not exhaustive) | Efficacy in weight loss/glycemic control | Advantages | Disadvantages | Impact on body weight/glycemic traits | Refs |
|---|---|---|---|---|---|---|
| Intragastric balloons | ① Gastric volume↓ ② Stimulation of afferent mechanosensitive receptors in the gastric wall ③ Delayed gastric emptying ④ Alterations in GI hormones |
Total body weight loss (same below): 5-15% |
① Globally used ② Easy placement and removal ③ Reversibility ④ Less invasive |
① Temporary use only (6 months maximum) ② Modest weight reduction ③ GI side effects ④ Uncertain long-term safety ⑤ Weight regain |
Improvement or remission of T2DM | (155, 165–174) |
| Electrical stimulation systems | ① Gastric accommodation↓ ② Delayed gastric emptying ③ Satiety↑ ④ Calorie intake↓ |
9.2% at 1 year 8.0% at 2 years |
Avoidance of permanent nerve damage |
① Multiple side effects ② Relatively invasive and requires intraperitoneal violation (vagal nerve blockade) |
||
| Gastric emptying systems | ① Fastened gastric emptying ② Caloric intake↓ |
15-20% | ① Long durability ② No increase in eating disorder incidence ③ Technically easy ④ Approved for higher BMI |
① Device-specific risks: electrolyte abnormalities, nausea, and vomiting ② Gastrostomy tube requires maintenance ③ Potassium chloride supplementation and PPIs are commenced to reduce acid loss and potential potassium depletion due to aspiration of gastric contents |
||
| Endoscopic endoluminal bypass liners (NOT FDA-approved) | Limitation of intestinal bypass component of bariatric procedure | 15-20% | ①Reversibility ② Improved glycemic control |
① Multiple side effects ② Uncertain long-term safety ③ Fluoroscopic placement |
||
| Other (Duodenal mucosal resurfacing) | ① Absorption of nutrients↓ ② Enhanced cretin effect |
Mean weight loss of 3.1kg at 3 months Not significant at 6 months |
① No incision ② Restored insulin sensitivity ③ Promotes weight loss |
① Modest weight loss ② Fluoroscopy needed ③ More data required |
||
| Hydrogel particle | ① Gastric volume↓ ② Satiety↑ ③ Calorie intake↓ |
5-15% | ① Long durability ② No increase in eating disorder incidence ③ Convenient |
① Uncertain long-term safety ② Modest weight loss ③ More data required ④ Expensive |
Improved insulin sensitivity |
(T2) DM, (type 2) diabetes mellitus; BMI, body mass index.