Safety and Efficacy of EndoBarrier in Subjects With Type 2 Diabetes Who Are Obese

Inclusion Criteria:

* Males/females aged ≥ 21 years and ≤ 65 years
* Diagnosis of Type 2 Diabetes for ≤ 20 years
* Obese individuals (BMI ≥ 30 kg/m2 and ≤ 55 kg/m2)
* Stable doses (at least 3 months) of up to two anti-T2DM medications (MET, SU, DPP-4i or TZD)
* Glycemic state: HbA1c at screening ≥ 7.5% and ≤ 10.0%.
* Subjects willing to comply with study requirements
* Subjects who have signed an informed consent form

Exclusion Criteria:

* Diagnosis of type 1 diabetes mellitus or having any history of ketoacidosis
* C-peptide \< 1.0 ng/mL
* Triglyceride level \> 400 mg/dL
* Vitamin D deficiency (\<20 ng/mL)
* Male subjects with serum Creatinine \>1.5 mg/dl or female subjects with Creatinine \>1.4 mg/dL
* Uncorrectable bleeding diathesis, platelet dysfunction, thrombocytopenia with platelet count less than 100,000/microliter, or known coagulopathy
* Height \< 5 feet (152.4 cm)
* Current alcohol or drug addiction
* Symptomatic kidney stones or gallstones within 6 months prior to randomization
* Chronic pancreatitis or acute pancreatitis within 12 months of randomization
* Diagnosis of osteoporosis or currently taking bisphosphonates or teriparatide
* Diagnosis of an autoimmune connective tissue disorder (e.g., lupus erythematosus, scleroderma)
* Active gastroesophageal reflux disease \[GERD\] uncontrolled with a Proton Pump Inhibitor (PPI)
* Thyroid disease unless controlled with medication
* Currently taking Non-Steroidal Anti-Inflammatory Drugs \[NSAIDs\] (e.g., aspirin, ibuprofen, etc.) within 10 days prior to randomization and/or there is a need or expected use of these agents during the trial 12 months post index procedure
* Currently taking prescription antithrombotic therapy (e.g., anticoagulant or antiplatelet agent) within 10 days prior to randomization and/or there is a need or expected need to use during the trial 12 months post index procedure
* Currently taking systemic corticosteroids, drugs known to affect GI motility, prescription/over-the-counter weight loss medications, or medications known to cause significant weight gain or weight loss within 30 days prior to randomization and/or there is a need or expected need to use these medications during the trial 12 months post index procedure
* Medication for type 2 diabetes other than MET, SU, DPP-4i, and TZD (e.g., GLP1 or insulin) within 3 months of screening
* Chronic use of narcotics, opiates, benzodiazepines, or other addictive tranquilizers
* Allergy or hypersensitivity to ceftriaxone, cephalosporins, penicillin, or any equivalent antibiotics
* Active Helicobacter pylori infection (Note: Subjects may be eligible after undergoing 2 weeks of antibiotic treatment without re-screening)
* Previous GI surgery or abnormal GI anatomical finding that could preclude the ability to place the EndoBarrier device, liner or affect the function of the liner
* Abnormal pathologies or conditions of the gastrointestinal tract, including current ulcers or Crohn's disease, history of atresias or untreated stenoses, current upper gastrointestinal bleeding conditions within 3 months of randomization
* Any condition or major illness that places the subject at undue risk by participating in the study
* Poor dentition not allowing complete chewing of food
* Enrolled in another investigational study within 3 months of screening for this study (Enrollment in observational studies is permitted)
* Residing in a location without ready access to study site medical resources
* Documented weight loss of \>10 pounds anytime during the 3 months preceding randomization
* Positive stool guaiac at time of screening