Endoscopic duodenal mucosal resurfacing improves glycaemic and hepatic indices in type 2 diabetes: 6-month multicentre results.
Aminotransferase levels
Blood Glucose
Duodenal Mucosal Resurfacing
Glycated Haemoglobin A1c
Insulin Resistance
Metabolic Syndrome
Metabolomics
NAFLD
Non-Alcoholic Fatty Liver Disease
T2DM
Type 2 Diabetes Mellitus
therapeutic endoscopy
Journal
JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
10
08
2019
revised:
27
09
2019
accepted:
29
10
2019
entrez:
11
2
2020
pubmed:
11
2
2020
medline:
11
2
2020
Statut:
epublish
Résumé
Insulin resistance is a core pathophysiological defect underscoring type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Both conditions improve with duodenal exclusion surgery. Duodenal mucosal resurfacing (DMR) is an endoscopic intervention developed to treat metabolic disease which has been shown to improve glycaemia in patients with poorly controlled T2DM. Herein, we aimed to further analyse the effects of DMR on hepatic and metabolic parameters in this patient cohort. Eighty-five patients with T2DM who received endoscopic DMR treatment were enrolled from 5 centres and followed up for 6 months. We assessed safety in all patients. Efficacy was evaluated in patients who received at least 9 cm of duodenal ablation (n = 67). Endpoints included HbA1c, fasting plasma glucose, weight and aminotransferase levels. Metabolomic analysis was conducted in a subgroup (n = 14). Data were analysed using paired The DMR procedure was completed with no intraprocedural complications in the entire cohort. HbA1c was lower 6 months after DMR than at baseline (7.9 ± 0.2% Hydrothermal ablation of the duodenum by DMR elicits a beneficial metabolic response in patients with T2DM. DMR also improves hepatic indices, potentially through an insulin-sensitizing mechanism. These encouraging data deserve further evaluation in randomized controlled trials. Hydrothermal duodenal mucosal resurfacing (DMR) is an endoscopic technique designed to treat metabolic disease through ablation of the duodenal mucosa. DMR is a safe procedure which improves glycaemia and hepatic indices in patients with type 2 diabetes mellitus. DMR is an insulin-sensitizing intervention which can be complementary to lifestyle intervention approaches and pharmacological treatments aimed at preserving the pancreas and liver from failure. DMR is a potential therapeutic solution for patients with type 2 diabetes and fatty liver disease.
Identifiants
pubmed: 32039394
doi: 10.1016/j.jhepr.2019.10.006
pii: S2589-5559(19)30128-4
pmc: PMC7005649
doi:
Types de publication
Journal Article
Langues
eng
Pagination
429-437Informations de copyright
© 2019 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).
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