Guidance
The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Implantation of a duodenal-jejunal bypass liner for managing type 2 diabetes, in March 2015.
January 2018: The device used in this procedure (EndoBarrier) no longer has a current CE mark. The CE mark is necessary for medical devices to be marketed in the European Union. A non CE marked device can only be used in the context of clinical investigations with MHRA and research ethical approval.
Description
Type 2 diabetes is caused by insulin resistance with or without inadequate pancreatic insulin secretion. It is most commonly seen in people with obesity or who are overweight. Presenting symptoms include polyuria, polydipsia, and fatigue. Type 2 diabetes is commonly associated with raised blood pressure, abnormal blood lipid levels and a tendency to atherosclerosis. This combination is often described as the ‘metabolic syndrome’, which is associated with fatty liver and abdominal adiposity (increased waist circumference).
Type 2 diabetes is managed by lifestyle and dietary changes, exercise or antidiabetic drugs (as recommended in NICE’s guideline on type 2 diabetes). If blood glucose levels remain poorly controlled, subcutaneous insulin injections may be needed.
Coding and clinical classification codes for this guidance.