Novel Diabetes Treatment: Electrical Pulses Improve Glycemic Control Without Insulin

A minimally invasive technique that delivers electrical pulses to the duodenum helps reverse insulin resistance in type 2 diabetes.

Highlights:

Bypassing a portion of the small intestine can improve insulin control in type 2 diabetes patients
Regenerating the tissue in the small intestine section increases the body's ability to respond to insulin
Ablation, a technique that uses heat to modify the lining of the small intestine, has been investigated as a way to improve glycemic control in type 2 diabetes patients

A procedure that uses controlled electrical pulses to induce changes in the lining of the first part of the small intestine could allow patients with type 2 diabetes to stop taking insulin while still maintaining glycemic control, suggested a preliminary first-in-human study that will be presented at Digestive Disease Week (DDW) 2023.

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‘Revolutionary endoscopic technique reverses insulin resistance in type 2 diabetes patients, allowing many to maintain glycemic control without insulin. A promising alternative to costly and potentially harmful medication. #Type2Diabetes #InsulinResistance #EndoscopicTechnique’

Revolutionizing Diabetes Treatment With An Endoscopic Electrical Pulse Procedure

"The potential for controlling diabetes with a single endoscopic treatment is spectacular," said Celine Busch, the study's lead researcher and Ph.D. candidate in gastroenterology 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."

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Endoscopic Electrical Pulse Treatment for Type 2 Diabetes

Semaglutide alone can sometimes allow patients with type 2 diabetes to stop taking insulin, but only in roughly 20% of cases, according to Busch. In this trial, 12 of 14 patients (or 86% of the total) maintained satisfactory glycemic control without insulin for a year, indicating that the improvement is due to the operation rather than the semaglutide alone. To put these findings to the test, the authors have begun work on a double-blind randomized controlled experiment.

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"While drug therapy is 'disease-controlling,' it only reduces high blood sugar as long as the patient continues taking the medication," said Jacques Bergman, M.D., Ph.D., principal investigator on the study and professor of gastrointestinal endoscopy at Amsterdam University Medical Center. "This one procedure is 'disease-modifying' in that it reverses the body's resistance to its insulin, the root cause of type-2 diabetes."

Small Intestine Ablation: A Potential Solution For Type 2 Diabetes Glycemic Control

Previous researchers investigated the impact of ablation, which uses heat to modify the lining of the small intestine, after observing that patients who underwent gastric bypass had improved insulin control immediately after the surgery, even before any weight loss could occur, indicating that bypassing this portion of the small intestine plays a role in type 2 diabetes glycemic control.

According to Busch, researchers speculated that persistent exposure to a high-sugar, high-calorie diet causes an unknown change in this part of the small intestine, making the body resistant to its insulin. Researchers believe that regenerating the tissue in this section of the gut increases the body's ability to respond to its insulin, especially in type 2 diabetes patients whose bodies still manufacture some insulin.

Source-Medindia