2023-04-30 07:31:46
Type 2 diabetes most often develops in people over the age of 45, but more and more children, adolescents and young adults are also developing diabetes. Blood sugar-lowering drugs can be expensive, and injecting insulin has several side effects, including the risk of low blood sugar and weight gain.
The new procedure that uses controlled electrical pulses to induce changes in the lining of the first part of the small intestine offers hope that patients with type 2 diabetes can stop taking insulin.
“The potential for diabetes control with a single endoscopic treatment is spectacular,”
explains one of the lead authors, Celine Busch, a researcher in gastroenterology at the Medical Center of the University of Amsterdam: “one of the biggest advantages of this treatment is that a single outpatient endoscopic procedure can control blood sugar levels, which is a big improvement over drug therapy, where patients take medication daily”.
The study, preliminary, is conducted in 14 patients who underwent an endoscopic procedure in which alternating electrical pulses were delivered to the duodenum, a part of the lining of the small intestine located just below the stomach. After the hour-long procedure, the patients were put on a calorie-restricted liquid diet for 2 weeks and then started taking semaglutide, a diabetes drug, up to 1 mg per week. Semaglutide alone sometimes allows patients with type 2 diabetes to stop taking insulin, but only in about 20% of cases. In this study,
- 12 of the 14 patients, or 86%, maintained good glycemic control without insulin for one year;
- this suggests that the improvement is related to the procedure and not just to the semaglutide.
- A future double-blind randomized controlled trial will have to confirm these results. But whereas drug therapy provides disease control and only reduces hyperglycemia as long as the patient continues to take the drug, the endoscopic procedure is truly disease-modifying in that it
that it reverses the body’s resistance to its own insulin,
- the root cause of type 2 diabetes.
What reasoning, what process? The researchers point to previous studies that have suggested that a type of bariatric surgery, gastric bypass, provides improved insulin control immediately after surgery, even before weight loss, indicating that bypassing this part of the small intestine plays a role in the glycemic control of type 2 diabetes. The researchers therefore hypothesized that chronic exposure to a diet high in sugar and calories leads to an as yet unknown change in this part of the small intestine , making the body resistant to its own insulin. From there, they hypothesized that rejuvenating the tissues of this part of the intestine would improve the body’s ability to respond to its own insulin, especially in patients with type 2 diabetes whose body still produces insulin. From there was born the concept of electrical stimulation, via endoscopy.
The study was fully funded by Endogenex, the company that developed the technology for this endoscopic procedure.
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