Published on 19 September 2016

A study on a procedure that changes how the body absorbs and processes sugar has reported lower cases of hyperglycaemia in people with type 2 diabetes.

A study on a procedure that changes how the body absorbs and processes sugar has reported lower cases of hyperglycaemia in people with type 2 diabetes.

Hyperglycaemia, or a hyper, is when there is too much sugar in the bloodstream and can affect people with both type 1 and type 2 diabetes.

The Revita study, carried out by researchers at Fractyl laboratories and recently published in the journal Diabetes Care, looked at the results of an endoscopic duodenal mucosal resurfacing for the treatment of type 2 diabetes.

The study looked at how it could be possible for people with type 2 diabetes to reduce their risk of having hypers

The Revita duodenal mucosal resurfacing (DMR) procedure is a new therapy for people with type 2 diabetes that targets the area of the small intestine called the duodenum. The duodenum is where absorption of nutrients begins and hormones that control blood sugar levels are produced. The treatment is designed to safely alter the inner surface of the duodenum to change how the body absorbs and processes sugar. In doing so, researchers looked at whether it could be possible to improve blood sugar control.

The results showed a significant improvement in hyperglycaemia in people with type 2 diabetes whose condition was poorly controlled and on one or more oral antidiabetic treatments.

Researchers reported minimal gastrointestinal symptoms after the treatment, which they found significantly improved glycaemic control in people with type 2 diabetes. One of the main findings included the effect of lowering fasting hyperglycaemia, which suggested the treatment could have an impact on the body’s sensitivity to insulin.

Harith Rajagopalan, MD, PhD, Co-Founder and CEO of Fractyl, said: “This is the first peer-reviewed publication of human clinical data from the proof-of-concept trial. This study is part of a growing body of evidence that suggests Revita DMR may address the underlying metabolic complications of insulin resistance and could represent a new treatment for option for people with type 2 diabetes who are failing oral medications or have evidence of fatty liver disease.”

So far 40 people have been treated across sites in the United Kingdom, Chile, Italy, Netherlands and Belgium.

Francesco Rubino, Consultant Surgeon, Kings College London, originally identified the link that gastrointestinal surgery and improving blood sugar levels could be more effective than any lifestyle or pharmaceutical intervention; including the potential to reverse type 2 diabetes in the long-term.

Professor Rubino said: “The gastrointestinal tract plays a major role in the physiologic regulation of glucose metabolism, so it is plausible that gastrointestinal changes in response to years of exposure to certain foods might contribute to the development of metabolic diseases, especially type 2 diabetes.

“There is now a solid biological rationale to consider the gastrointestinal tract as an ideal target for anti-diabetes interventions. In fact, recently recognised new guidelines from international diabetes organisations recommend the use of gastrointestinal surgery as a standard treatment option in certain patients with type 2 diabetes. However, because surgery is not suitable as mass treatment for the hundreds of millions of patients suffering from diabetes, less invasive approaches that harness the mechanisms of major surgery and reproduce some of its beneficial effects could provide a real opportunity for improvement of diabetes care. The early results with Revita DMR are quite encouraging in this regard.”

London-based Russell Pearson, 61, was diagnosed with type 2 diabetes eight years ago. He underwent the Revita procedure after his medications increased and his blood sugar levels get gradually worse, causing him to worry about the long-term health effects of the condition.  

Upon discussion with his doctor - Dr Rehan Haidry, Consultant Gastroenterologist and Director of Endoscopy at University College London - Russell underwent the Revita DMR procedure, and has since achieved positive results, with a reduction in his blood sugar levels and weight loss observed.

Dr Eleanor Kennedy, DRWF Research Manager, said: “Whilst this is an interesting piece of research that strengthens our belief that the biology of the gastrointestinal tract plays an interesting but complex role in diabetes this is a relatively small study in just 40 people, the results of a bigger trial could perhaps pave the way to a more widespread use of a less invasive technique that mimics the beneficial effects of metabolic surgery in patients with the condition.”

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