A new one-hour procedure may mean an end to daily insulin doses for thousands of people with type 2 diabetes. While insulin shots can control the condition, they can also be uncomfortable and require regular administration based on precise calculations. Scientists have now discovered that stimulating the lining of the small intestine with mild electrical pulses in a one-time treatment keeps blood sugar levels under control with equal effectiveness.
In a recent clinical trial, 86% of type 2 patients who underwent the procedure were able to manage their condition through diet and pills alone, completely stopping their need for insulin. Type 2 diabetes is associated with poor diet, a sedentary lifestyle, and obesity, characterized by high blood sugar levels. It develops when the body does not produce enough insulin (a hormone secreted by the pancreas to help muscle cells absorb sugar from the blood for energy) or when body cells become resistant to this hormone. Over time, high blood sugar or uncontrolled levels can damage vital organs and narrow blood vessels, leading to decreased circulation.
Medications like metformin, along with lifestyle changes, can help insulin work more effectively. However, nearly a quarter of patients require daily injections of synthetic insulin, which means repeated doses based on their food intake. The new procedure, known as ReCET (ReCelling through Electrical Treatment), could allow type 2 patients who take insulin to stop using it. (Type 2 patients still produce some insulin, unlike those with type 1 who would not benefit from ReCET.)
The electrical pulses are delivered to the lining of the duodenum (the first part of the small intestine) through an endoscope—a thin tube that passes through the throat. The duodenum is located just below the stomach, where most nutrients from food are absorbed. It is believed that high blood sugar levels cause changes in the cells lining this part of the intestine, making the body resistant to its own insulin. The electrical pulses create small holes in these cells, causing them to die, which allows the intestinal lining to replace them with new, healthy cells that properly respond to insulin in the body, improving blood sugar control.
After undergoing this procedure, 14 patients in the trial were placed on a liquid diet for a week to heal the gastrointestinal tract. They then began taking the diabetes drug semaglutide (brand name Ozempic), which helps the pancreas release the appropriate amount of insulin. Semaglutide alone can sometimes allow type 2 patients to stop taking insulin—but only in about 20% of cases. However, when the drug was taken after the procedure, 86% were able to maintain good blood sugar control without the need for insulin. No side effects from the procedure were reported.
Researchers from the Amsterdam University Medical Center, who presented their findings at the Digestive Disease Week conference in Chicago earlier this year, are now conducting larger studies and comparing the treatment to a placebo. This is not the first time that gastrointestinal procedures have helped treat type 2 diabetes. Gastric bypass surgery can treat the disease even before patients lose weight by inducing changes in gut hormones that encourage stable blood sugar levels. Other studies have examined the use of heat ablation to alter the intestinal lining, but this can damage the intestinal lining.
