A large number of patients with type II diabetes can be helped to refuse insulin injections: this will help the minimally invasive endoscopic method, proposed this fall at the next event of UEG Week 2020.
Scientists representing the Center for Medicine at the University of Amsterdam, the Netherlands, investigated the effectiveness of an innovative minimally invasive procedure involving the remodeling of the duodenal mucosa . Simultaneously with the procedure, the patients took antidiabetic drugs (receptor antagonists of the glucagon-like peptide-1 GLP-1 RAs) and led an exceptionally healthy lifestyle. The primary experiment involved 16 patients with insulin-dependent type II diabetes mellitus.
Endoscopic DMR was performed on an outpatient basis using wire catheterization. During the procedure, the doctors performed lifting and ablation of the mucous tissue in the duodenum. It is known that the intestinal mucous structures are pathologically altered due to an unhealthy lifestyle and unhealthy diet with increased consumption of sugars and animal fats. Negative factors affect the production of basic hormones, including those that affect insulin resistance and provoke the development of diabetes. Special tissue remodeling of the duodenum helps to start cells in a new mode and restore the process of hormonal production.
The research work showed that about 3/4 of insulin-dependent patients with type II diabetes participating in the experiment of the therapeutic endoscopic method, after six months, lost the need for insulin injections. Laboratory values of glycated hemoglobin in such patients decreased from 7.5% to 6.7%, which indicates a positive diabetic compensation.
Participants with a satisfactory response to remodeling therapy also showed a marked decrease in BMI (body mass index) - from about 30 kg / m² before the experiment to 25 kg / m² within a year after treatment. In addition, a percentage decrease in liver fat content was found - from 8% to 4.5% within six months. Fatty liver disease is one of the main risk factors for the onset of insulin resistance syndrome, which includes increased blood pressure , weight gain and impaired fat metabolism .
The 25% of participants who did not find a response to the remodeling treatment continued to take insulin. However, the average daily amount of the drug for them was reduced by more than two times (from about 35 IU before therapy to 17 IU within a year after the procedure).
According to one of the co-authors of the work Suzanne Meiring, the new method is fundamentally changing the approach to diabetes treatment. A single procedure in conjunction with sugar-lowering drugs and nutritional correction is often enough to refuse insulin injections and improve metabolic processes in the patient's body. Most of the patients after the study were able to complete insulin therapy, which is also accompanied by negative side effects - in particular, increased body weight and signs of hypoglycemia .
Scientists will soon announce a larger-scale scientific work.
More information about the experiment can be found on the Medicalxpress website page