One-Hour Diabetes Procedure Offers Fresh Hope For Ditching Insulin

Topline

Researchers on Friday hailed a new procedure that could allow type 2 diabetics to control their blood sugar levels without having to take insulin, early findings that offer millions of people hope they may one day manage the disease without needing to rely on frequent doses of expensive medication for the rest of their lives.

Key Facts

The procedure, which lasts an hour and zaps part of the small intestine with controlled pulses of electricity, showed promise at helping people manage type 2 diabetes without insulin for a year, according to findings from an early-stage study, which have not yet been published or peer reviewed.

The endoscopic procedure is nonsurgical—it involves flexible tubes, lights and cameras that help doctors see inside the body—and patients can be discharged on the same day, the researchers said.

Of the 14 type 2 diabetics who underwent the procedure, 12, or 86%, controlled their blood sugar well for a year without taking insulin.

While the patients did take weekly injections of semaglutide, a drug that helps diabetics control blood sugar, the researchers said the drug only helps around one in five people quit insulin, suggesting the procedure is responsible for most of the improvement.

The researchers said they are working to initiate more rigorous clinical trials to confirm the role of the procedure and the findings, which will be presented at the Digestive Disease Week conference in early May.

Jacques Bergman, who is the study’s principal investigator, a professor of gastrointestinal endoscopy at Amsterdam University Medical Center and on the advisory board of Endogenex, the company that funded the research and owns the technology used for the procedure, said the “procedure is ‘disease-modifying’ in that it reverses the body’s resistance to its own insulin,” which is the root cause of type 2 diabetes.

Crucial Quote

“The potential for controlling diabetes with a single endoscopic treatment is spectacular,” said Celine Busch, the study’s lead researcher and PhD candidate in gastroenterology at Amsterdam University Medical Center. “One of the biggest advantages of this treatment is that a single outpatient endoscopic procedure provides [blood sugar control], a potential improvement over drug treatment, which depends on patients taking their medication day in, day out.”

What We Don’t Know

It is not totally clear why the procedure appears to improve the body’s ability to respond to insulin on its own. Busch said some researchers theorize that long-term exposure to a high-sugar and high-calorie diet changes this part of the small intestine in a way that makes it resistant to the body’s own insulin.

Key Background

Diabetes is a long-term health condition that affects how the body processes food. In particular, it changes how the body produces or responds to insulin, the hormone responsible for regulating levels of sugar in the blood. There is no cure and without proper control—usually through frequent administration of insulin—blood sugar levels can soar or sink to dangerous levels, which can be fatal and contribute to a variety of health issues over time including kidney problems and vision loss. It is the eighth leading cause of death in the U.S., according to the CDC, which warns the condition is possibly underreported. Type 2 diabetes, where the body does not use insulin optimally, accounts for an estimated 90% to 95% of diagnosed cases of diabetes. Most remaining cases are classed as type 1, believed to be the body’s immune system attacking itself and preventing insulin production, and a small set of pregnant people develop a usually transitory form of the disease called gestational diabetes. Insulin manufacturers have come under heavy fire in recent years over the pricing of their life saving insulin products and many are being sued for the high prices.

Big Number

37.3 million. That’s how many people in the U.S. have diabetes, according to the CDC, around 11% of the population. One in five diabetics—some 8.5 million—are unaware they have the condition. Another 96 million adults—more than a third—have prediabetes, the agency said, more than eight in 10 are unaware. Prediabetes is a serious health condition characterized by high levels of sugar in the blood that haven’t reached high enough levels to warrant a diagnosis of type 2 diabetes.

Further Reading

Eli Lilly Pushes For Fast-Track Approval Of Mounjaro As Weight-Loss Drug (Forbes)

The Long, Long Wait for a Diabetes Cure (NYT)

100 years of insulin: How diabetes stopped being a death sentence (Telegraph)

Source: https://www.forbes.com/sites/roberthart/2023/04/28/one-hour-diabetes-procedure-offers-fresh-hope-for-ditching-insulin/