Hour-long endoscopic procedure may eliminate need for insulin for diabetes

San Francisco: An hour-long endoscopic procedure that uses controlled electrical pulses to modify the lining of the first part of the small intestine may help patients with Type 2 diabetes stop taking insulin and still maintain glycemic control, a new study revealed on Friday.

More than 37 million Americans have diabetes, and more than 90 per cent of them have Type 2 diabetes, according to a study to be presented at the Digestive Disease Week (DDW) 2023 in the US.

Type 2 diabetes most often develops in people over 45 years of age, but more and more children, teens and young adults are also developing it. Also, glucose-lowering medication can be expensive, and the insulin injection has several side-effects, including the risk of low blood sugar and weight gain.

"The potential for controlling diabetes with a single endoscopic treatment is spectacular," said Celine Busch, the study's lead researcher and PhD candidate at Amsterdam University Medical Center.

"One of the biggest advantages of this treatment is that a single outpatient endoscopic procedure provides glycemic control, a potential improvement over drug treatment, which depends on patients taking their medication day in, day out," she added.

In the study, 14 patients underwent an endoscopic procedure in which alternating electrical pulses were delivered to the duodenum, a portion of the lining of the small intestine just below the stomach.

The patients were discharged the same day after the hour-long procedure and placed on a calorie-controlled liquid diet for two weeks. They were then put on semaglutide, a diabetes medication, titrating up to 1 mg per week.

According to Busch, Semaglutide on its own sometimes allows patients with Type 2 diabetes to quit taking insulin, but only in about 20 per cent of cases.

In the study, 12 out of the 14 patients, or 86 per cent, maintained good glycemic control without insulin for a year.

"While drug therapy is 'disease-controlling', it only reduces high blood sugar as long as the patient continues taking the medication," said Jacques Bergman, principal investigator of the study, who is a professor at Amsterdam University Medical Center.

"This one procedure is 'disease-modifying' in that it reverses the body's resistance to its own insulin, the root cause of Type-2 diabetes," he added.