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DDW 2023: Endoscopic Procedure May Eliminate Need for Insulin in Type 2 Diabetes
Procedure alters the lining of the duodenum, known to play a role in glucose homeostasis
MONDAY, May 15, 2023 (HealthDay News) -- A one-hour endoscopic procedure, re-cellularization via electroporation therapy (ReCET), may eliminate the need for therapeutic insulin in patients with type 2 diabetes (T2D), according to study findings presented at the 2023 Digestive Disease Week, held from May 6 to 9 in Chicago.
The ReCET procedure uses electrical pulses to change the lining of the duodenum by inducing cell apoptosis and renewal. Research has shown that the duodenum plays a crucial role in glucose homeostasis in T2D, according to Celine Busch, from Amsterdam University Medical Center in the Netherlands, and colleagues.
“We know from bariatric surgery that bypassing the duodenum by a Roux-en-Y gastric bypass has an immediate and profound effect on T2D by improving the sensitivity to the body’s own insulin resistance,” Busch told Elsevier’s PracticeUpdate. “Performing invasive bariatric surgery for T2D is not feasible, but we can reach the duodenum easily via upper gastrointestinal endoscopy.”
Busch and colleagues conducted a single-arm, first-in-human study in 14 patients with T2D. Patients were aged 28 to 75 years old, had a body mass index of 24 to 40, and had a glycosylated hemoglobin level of 8 percent or lower. All patients underwent the ReCET procedure under deep sedation, followed by a two-week liquid diet. The patients began semaglutide treatment after the liquid diet.
All patients completed the six-month follow-up, and the ReCET procedure had a 100 percent technical success rate. Thirteen patients tolerated the maximum semaglutide dose. The researchers observed no device-related adverse events. At six months, 12 patients had been taken off insulin and showed significant improvement in glycemic control and treatment satisfaction.
“ReCET is a feasible and safe endoscopic treatment, and once efficacy is confirmed in larger controlled studies, this might change the way we treat T2D,” Busch told Elsevier’s PracticeUpdate. “The treatment is compliance-free, which is an important issue in the medical treatment of T2D. In addition, the treatment is disease-modifying: It improves the patients’ sensitivity to their own insulin, thus tackling the root cause of the disease versus drug therapy, which, at best, is disease-controlling.”
