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Type 2 diabetes therapy experimentally possible without the need for insulin?

A new proof of concept study has shown positive results in type 2 diabetes therapy. If such treatment proves effective, it would mean that patients can live without insulin. The study’s authors presented their research at UEG Week Virtual 2020. This is a conference organized by United European Gastroenterology, a professional non-profit organization for digestive health specialists.

New concept for type 2 diabetes therapy

treatment with insulin for diabetes by injection

Treatment for type 2 diabetes with insulin may be needed if the person cannot keep blood sugar at normal levels. Such therapy can take the form of injections, pens, pumps or inhalers. This stimulates the cells in the body to absorb more blood sugar. However, people’s perception of the side effects of insulin treatment can be very high. As a result, doctors may be less likely to prescribe insulin. If they do, however, their patients may not be taking insulin on a regular basis. Consequently, therapies that can help avoid perceived side effects can be helpful. This can help health professionals make sure people are keeping up with their prescribed treatment and prevent the risk of serious health problems.

doctor for gastroscopy with duodenal mucosal resurfacing or dmr innovative technology as diabetes type 2 therapy

In this context, the researchers behind the present study used a novel technique that scientists first applied to humans in 2016. Based on these preliminary results, it appeared promising. The technique is known as Duodenal Mucosal Resurfacing (DMR). The duodenum is the first part of a person’s small intestine. In DMR, the mucosal layer of the duodenum is raised to allow the exposed area to be ablated with heated water. This is a process that removes the cells in the target area. The researchers who developed this DMR technique attempted to reproduce the beneficial effects of bariatric surgery (gastric bypass surgery) on blood sugar levels using a less invasive technique. DMR can be performed on an outpatient basis and is minimally invasive. It is an endoscope with a catheter that doctors use to gain access to the duodenum.

Promising study results

woman with blood glucose meter prepares sample from her finger

The study included 16 participants with type 2 diabetes who were treated with insulin. Of the study participants who used type 2 diabetes therapy with DMR, 12 (75%) were able to stop using insulin. After 6 months, they were also able to maintain their blood sugar levels. The test subjects also saw a number of benefits for their metabolism. The participants’ HbA1c levels, which determine a person’s glucose level, were all below 7.5%. After 12 months it also fell further to 6.7%. Those who responded to treatment saw their body mass index decrease from an average of 29.8 kg per square meter (kg / m 2) before the start of the study to 25.5 kg 12 months after the study. The fat in the livers of the participants decreased after 6 months from 8.1% to 4.6%.

male bypass operation by dmr diabetes type 2 therapy without the need for insulin

Even for those participants who still needed insulin, the amount required was reduced from an average of 35 to 17 units per day after 12 months. Many patients with type 2 diabetes would be very happy to be able to discontinue insulin therapy, as such treatment is associated with weight gain and hypoglycemic events. The intervention combined two innovative treatments. No details are available on the side effects of the two treatments (DMR and GLP-1 agonist). Although this type 2 diabetes therapy shows so much promise, larger studies are needed to find out the results to confirm. It is important that it is not yet clear how and why the therapy appears to be working. Scientists believe it might work because the mucosal cells affected by DMR therapy undergo changes in response to unhealthy diets that can promote insulin resistance.