Duodenal mucosal resurfacing plus liraglutide eliminates want for insulin in kind 2 diabetes

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February 03, 2021

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This study was funded by Fractyl Laboratories Inc. Van Baar does not report any relevant financial information. In the full study you will find all relevant financial information from all other authors.

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Adding liraglutide and lifestyle advice to resurfacing the duodenal lining eliminated the need for insulin therapy in most patients with type 2 diabetes over an 18 month period, according to a feasibility study.

“[In] this feasibility study, [duodenal mucosal resurfacing (DMR)], combined with [liraglutide] and backed by lifestyle advice, eliminated the need for insulin therapy in most cases [type 2 diabetes] Patients after 6, 12 and 18 months with simultaneous improvement in their glycemic and metabolic health ” Annieke CG off Baar, MD, PhD student, from the Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, Netherlands, and colleagues wrote. “Given the limited size and uncontrolled nature of this study, randomized sham-controlled trials are needed to confirm its results.”

The study by Van Baar and colleagues included 16 patients with insulin-treated type 2 diabetes who underwent a single renewal of the duodenal mucosa (DMR). After the DMR, the researchers assigned patients a 2-week post-procedural diet and then introduced the glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide. The percentage of patients without insulin with an HbA1c of less than 7.5% at 6 months was used as the primary endpoint. Secondary endpoints included changes in multiple glycemic and metabolic parameters and the percentage of responders at 12 and 18 months, respectively.

The results showed that successful surface resurfacing of the duodenal mucosa without procedural serious adverse events was performed in all patients. 69% of patients had no insulin therapy and had an HbA1c value of 7.5% or less at 6 months. After 12 months, 56% of patients remained without insulin and 53% after 18 months.

According to the researchers, there were significant improvements in the assessment of the homeostatic model for insulin resistance, BMI, weight and liver fat percentage in all patients.

“[It] It would also be interesting to watch what happens after 18 months and see if retreatment with DMR is effective, ”the investigators wrote.

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