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A new procedure encourages cell growth and encourages the pancreas to produce insulin again in some people.
A new treatment that encourages cell growth can potentially put diabetes in remission in some patients.
The researchers described the new procedure in a study recently published in Diabetes Care.
The researchers studied a process involving the regeneration of cells on the surface of the patient's small intestine.
These new cells then push the pancreas to produce adequate amounts of insulin again.
This could allow many people with type 2 diabetes taking oral medications to avoid insulin injections and put their disease back into remission.
This promising new treatment – known as "duodenal lining resurfacing" – involves the insertion of a thin tube with a small balloon attached to one end of the sedated patient's mouth and stomach.
The tube is then placed on top of the small intestine, at which point the balloon is filled with warm water.
The heat of this hot water destroys the endothelial cells on the surface of the small intestine – a technique called ablation therapy.
This then promotes the growth of new healthy cells and improves the patient's ability to produce insulin.
Although the observation of results is still in its infancy, this method has been effective for more than a year after the first treatment of study participants.
This is because the lining of the small intestine is largely responsible for the production of insulin.
Once the food has been digested in the stomach, they go to the small intestine, where the glucose produced by these foods is absorbed by the blood.
This process signals the pancreas to produce insulin. This insulin helps to transport glucose to all areas of the body that depend on it.
Without enough insulin, glucose accumulates in the blood.
This leads to dangerously high blood sugar levels that damage nerve endings and blood vessels throughout the body, including those of the eyes, fingers and toes.
The results of this new procedure were similar to those of gastric bypass patients.
The researchers said that there was an improvement in blood sugar in the study participants in a few days and weeks.
This improvement occurred regardless of diet or weight loss.
"In contrast to the common perception of type 2 diabetes, they found that low insulin production was a major factor for most people with type 2 diabetes, and not resistance to diabetes." 39, insulin, "explained Gretchen Becker, medical journalist and author of" The First Year: Type 2 Diabetes. "
Becker told Healthline that most patients with type 2 diabetes had different degrees of insulin resistance, but the same was true for people without diabetes.
While the bodies of these simply produce more insulin to compensate, a person with type 2 diabetes does not seem able to do so.
"Most genes related to type 2 diabetes relate to insulin production, not insulin resistance," Becker said.
She added that this explains why removal of the lining of the small intestine has been so effective in normalizing patients' ability to maintain healthy blood glucose levels.
Dr. George Grunberger, FACP, FACE, co-author of the survey and founder of the Grunberger Diabetes Institute in Michigan, told Healthline he was excited about the results of this and similar procedures.
"A few years ago, in Chile, a similar procedure was under study, consisting of inserting a balloon into the small intestine to serve as a liner, so that the food never touched the wall during the digestion, "explained Grunberger.
"As a result, patients' blood sugar levels were regulating themselves, simply by interrupting and preventing this interaction with the mucosa."
Since then, Grunberger said that everyone was trying to convince the Food and Drug Administration (FDA) of the safety of this type of procedure.
"If you catch people at the beginning of the diabetes game, you can put diabetes in remission by renewing or blocking the interaction with the lining of the small intestine, but for how long? We do not know yet. "
In his own practice, Grunberger found a success rate of 80-95% in diabetes remission through gastric bypass procedures or traditional gastric cuffs.
Both of these procedures involve the removal or limitation of contact with a certain part of the small intestine.
"These types of procedures have shown an almost immediate improvement in glucose tolerance," he said. "It means that it is not the result of calorie restriction or weight loss, but simply an interruption of this normal interaction with the mucous lining."
That being said, those who maintain long-term remission are always those who are able to lose weight successfully and maintain it.
"I have patients who have undergone gastric bypass and who were taking insulin for years before the surgery," explained Grunberger. "They do not need insulin anymore, they maintain an HbA1c rate of 5.2% and they come back every year just to say" Hello ".
Grunberger also has patients who do not usually change and regain most of the weight. But even in this case, many of them are able to use other antidiabetic drugs instead of going back to insulin injections.
The real obstacle that this study – and its peers – will have to overcome is the demonstration not only of its safety but also of its long-term effectiveness.
If a patient's success after resurfacing the duodenal mucosa lasts only a few years, it is unlikely that insurance companies will be willing to pay for it.
Ginger Vieira is an expert patient with type 1 diabetes, celiac disease and fibromyalgia. Find his books on diabetes on Amazon and connect with her on Twitter and Youtube.
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