Scientists have proposed a new therapy for type 2 diabetes. If proven effective, therapy may help some people stop insulin treatment.
Scientists have proposed a new therapy for the treatment of type 2 diabetes, a proof of concept that has shown positive initial results. If effective, therapy may mean that some people may stop taking insulin treatment.
The authors of the research presented their findings at UEG Week Virtual 2020, a conference organized by the United European Gastroenterology, a professional non-profit organization for experts in digestive health.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, a person may develop type 2 diabetes when his blood sugar is very high.
People get blood sugar, or blood sugar, mainly from the food they eat. Insulin helps cells to access this glucose to be used as energy. However, for a person with type 2 diabetes, either their body does not make enough insulin or their cells do not respond to insulin correctly.
This means that their blood glucose increases, which can lead to complications of diabetes, such as heart and kidney disease, visual impairment and loss of sensation in the limbs. The higher the blood sugar over time, the higher the risk of these complications.
According to the Centers for Disease Control and Prevention (CDC), 1 in 10 adults in the United States has diabetes, and 90–95% of these people have type 2 diabetes.
Doctors generally recommend lifestyle changes, such as being more physically active and eating healthier foods, to treat type 2 diabetes, as well as medications to manage a person’s blood pressure and blood sugar levels. .
If a person is unable to maintain their blood sugar at normal levels, insulin treatment may be necessary. This treatment can take the form of an injection, pen, pump, or inhaler. It encourages cells in a person’s body to absorb more blood sugar.
However, people’s perception about the side effects of insulin treatment can be quite clear. As a result, doctors may be less likely to prescribe insulin, and when they do, people may not take it regularly.
Consequently, treatments that can avoid these perceived side effects can be valuable in ensuring that people live with their prescribed treatment and avoid putting serious health issues at risk.
In this context, the researchers behind the current study used a novel technique that scientists reported for use in humans for the first time in 2016. Based on those preliminary results, it looked promising.
The technique is called duodenal mucus regeneration (DMR). The duodenum is the first part of a person’s small intestine. DMR involves lifting the mucous layer of the duodenum to allow segregation of the exposed area using hot water – a process that removes cells in the target area.
Researchers developing the DMR technique were trying to replicate the positive effect that blood sugar levels have with the less invasive technique in bariatric surgery (gastric bypass).
Studies on improving blood sugar control with bariatric surgery have concluded that in addition to weight loss, the duodenum has a direct effect from bariatric surgery.
DMR can occur in an outpatient setting and is minimally invasive. It includes an endoscope catheter to gain access to the duodenum.
The direct effect of the small intestine on glucose control appears to be from the presence of intrapithelial lymphocyte T cells. These are located between the gut cells involved in the absorption of nutrients from food.
Rats without these cells are protected from obesity and heart disease even when eating a high-fat diet.
These intraepithelial lymphocytes reduce the amount of gut hormone called GLP-1. Therefore, in the present study, researchers used regular doses of GLP-1 agonist called liraglutide on day 14.
They did this to counter the low levels of this essential lean, antidiabetic hormone. Study participants also received lifestyle counseling to help lower their blood sugar levels.
The study found 16 participants with type 2 diabetes received insulin treatment. Of the participants who received DMR therapy with liraglutide, 12 (75%) were able to stop using insulin after 6 months and maintain their blood sugar control.
Study participants also saw a variety of benefits for their metabolism.
Participants’ HbA1c readings, which determined an individual’s glucose control, were all reduced by 7.5%. After 12 months, it dropped to 6.7%.
Those who responded to treatment showed a decrease in body mass index of 29.8 kg per square meter (kg / m) on average.2) 25.5 kg / m before study2 After 12 months of study. Fat in participants’ liver decreased from 8.1% to 4.6% after 6 months.
Even for participants who still needed insulin, the required amount has dropped from an average of 35 units per day to 17 units per day after 12 months..
A researcher from Amsterdam University Medical Center, Netherlands and co-lead the study Drs. According to Susan Meering,
“A single endoscopic DMR may discontinue isolated insulin therapy with GLP-1 drugs and lifestyle counseling in a subset of patients with type 2 diabetes while improving their blood sugar control and overall metabolic health.”
“Many patients with type 2 diabetes are very happy to be able to quit insulin therapy, because insulin therapy comes with weight gain and hypoglycemic events.”
It is important to note that this is a very small, authentic study. The researchers presented it as a conference paper, and therefore, some details are available in the public domain for investigation.
The intervention combined two innovative treatments. No details of any side effects of the two treatments (DMR and GLP-1 agonists) are available. While promising, larger tests are required to confirm the results.
Importantly, precisely and how and why therapy appears to work is not yet clear.
Scientists believe this may work because mucosal cells that affect DMR therapy undergo changes in response to unhealthy diets that may promote insulin resistance.
Dr. “Based on the results of this study, a large international randomized controlled trial, called Revita T2Di Pivotal, will soon begin to investigate its effectiveness in greater numbers,” says Meering.