ForePass endoscopic bypass device for obesity and insulin resistance—metabolic treatment in a swine model

Metabolic surgery (MS) causes long-lasting type 2 diabetes (T2D) remission through mechanisms that are beyond the mere weight loss being linked to the bypass of the upper gut. The ForePass device combines a channelled gastric balloon with an intestinal sleeve and aims at reducing simultaneously food intake and nutrients’ absorption. In an experiment in four pigs, ForePass significantly lowered blood glucose and powerfully increased insulin-mediated glucose uptake, insulin clearance and reduced endogenous glucose production (EGP) over an observation period of 4 weeks without relevant complications. The weight gain was 79% lower than that observed in 4 sham-operated pigs. ForePass modified the composition of faecal microbiota raising the proportions of bacteria associated with metabolic health. Clinical studies are warranted.