{"id":16648,"date":"2011-05-31T09:04:48","date_gmt":"2011-05-31T13:04:48","guid":{"rendered":"http:\/\/asweetlife.org\/?p=16648"},"modified":"2016-01-05T11:56:40","modified_gmt":"2016-01-05T16:56:40","slug":"electrical-stimulation-to-the-stomach-a-new-way-to-treat-type-2-diabetes","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=16648","title":{"rendered":"Electrical Stimulation to The Stomach: A New Way to Treat Type 2 Diabetes"},"content":{"rendered":"

With today’s growing type 2 diabetes epidemic, there’s a need for new ways to treat the disease.\u00a0 Not everyone achieves good glycemic control with oral medications and some medications, like insulin, lead to weight gain.\u00a0 For type 2 diabetics who also suffer from obesity, any treatment that can lead to weight gain poses a problem.\u00a0 But there may be a new solution.\u00a0 The medical technology company \u00a0MetaCure<\/a> has developed an implantable device, known as the DIAMOND system (formerly Tantalus), which significantly reduces blood glucose levels by applying gentle electrical stimulation to the stomach during meals.<\/p>\n

\"\"<\/a>Electrical stimulation to the stomach sounds scary, right?\u00a0 According to Lior Teitelbaum, MetaCure\u2019s director of business development, it’s a lot less scary than bariatric surgeries because DIAMOND doesn’t change the anatomy of the stomach nor does it interfere with normal digestion processes.\u00a0 It also does not interfere with a patient\u2019s diet and daily routine since \u00a0once it’s implanted, DIAMOND<\/a> operates automatically without the patient feeling the stimulation. DIAMOND requires no activation on the patient\u2019s part.<\/p>\n

What’s particularly interesting about DIAMOND, which also induces early satiety, is that it isn’t being marketed as a weight loss device.\u00a0 Trial results<\/a> of the DIAMOND system showed that it brought about only modest reductions in weight (4-6 kg).\u00a0 It caused, however, a significant improvement in glycemic and metabolic control.\u00a0 In patients with type 2 diabetes, there was a reduction of 1 % in HbA1c.\u00a0 The trial also showed a positive effect on other metabolic parameters like reduction in systolic and diastolic blood pressure, improvement in \u00a0lipid profile, waist circumference reduction, and improvement in liver enzyme levels.\u00a0 So it became clear that DIAMOND held benefits for type 2 diabetics.\u00a0 According to Metacure, the DIAMOND system has shown a clean safety profile for over four years.\u00a0 They presented the safety profile results at The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting held in San Antonio in March 2011.<\/p>\n

I had the opportunity to speak to Lior Teitelbaum to learn more about DIAMOND and how it works.<\/p>\n

Who is DIAMOND for?<\/em><\/strong><\/p>\n

Our device targets type 2 diabetics who have tried all combinations of oral drugs and failed at glycemic control, and for those for whom insulin is not a good solution because it causes weight gain.\u00a0 It is specifically beneficial for populations that are not eligible for bariatric surgery (which requires BMI of 35 or higher).\u00a0 Diamond has shown good results for those with a BMI of 28-35.<\/p>\n

How and where is DIAMOND implanted?<\/em><\/strong><\/p>\n

The DIAMOND<\/a> device and electrodes are implanted in a minimally-invasive (laparoscopic) procedure under general anesthesia.\u00a0 Electrodes are attached to the stomach and the impulse generator and charging coil are located subcutaneously in a pocket.<\/p>\n

How does DIAMOND work?<\/em><\/strong><\/p>\n

It works by enhancing gastric muscle activity during meals.\u00a0 When a person eats, the stomach muscle is triggered by a nerve to contract. DIAMOND stimulates the muscle and causes a stronger (not faster or slower) contraction.\u00a0 The stimulation is given to the muscle during its refractory periods.\u00a0 This is a very important concept because DIAMOND is not a pacer.\u00a0 It modulates contractions without dictating a new contraction pattern.<\/p>\n

\"\"<\/a><\/p>\n

What’s the effect of stronger contractions?<\/em><\/strong><\/p>\n

We believe that the stronger contractions influence the hormone-based dialogue between the gastric system and the brain by affecting the release of gastric hormones in response to a meal.\u00a0 In essence this process strengthens and speeds up the body’s natural reaction to food consumption thereby normalizing – to some extent – the metabolic process.<\/p>\n

This sounds similar to the effect of GLP-1 drugs like Victoza<\/a>.<\/em><\/strong><\/p>\n

The major difference is that \u00a0GLP-1 drugs don’t work for everyone and many patients experience substantial side effects that make it hard for them to comply with the treatment.<\/p>\n

What’s the mechanism that actually lowers blood sugar and HbA1c? <\/em><\/strong><\/p>\n

We believe it is a combination of enhancing the metabolic response accompanied by lower food consumption per meal due to an earlier satiety sensation.<\/p>\n

Does the patient feel the DIAMOND working?\u00a0 The contractions?<\/em><\/strong><\/p>\n

Normally, no.\u00a0 If by chance the patient does feel something it’s just a tingling sensation and we adjust the parameters so that he does not continue to feel it.\u00a0 It’s not nauseating or painful in any way.<\/p>\n

What kind of upkeep does DIAMOND require?<\/em><\/strong><\/p>\n

\"\"<\/a>The DIAMOND has a rechargeable battery.\u00a0 Once implanted, DIAMOND<\/a> will operate automatically and will require no activation on your part. There is a need to charge the battery, using a portable charger once a week for about 45 minutes. Charging is wireless, non-invasive and painless, and can easily be done while reading or watching TV.<\/p>\n

How long does the battery last?<\/em><\/strong><\/p>\n

We have patients with over four years of follow up with no need of battery change. \u00a0The battery should work for a minimum of five years, but with a good recharging regime can work much longer.<\/p>\n

When the battery is exhausted does the patient need another procedure?<\/em><\/strong><\/p>\n

That may be the case if the patient wishes to continue with treatment, but it’s similar to a heart pacemaker, meaning it does not require another laparoscopic procedure.\u00a0 It will just require going under the skin with a local anesthetic to replace the impulse generator.<\/p>\n

Where is DIAMOND in clinical trials and when do you expect it to be available? <\/em><\/strong><\/p>\n

The DIAMOND system has had a CE mark since 2007 for treating type 2 diabetics who are also obese. It is already commercially available in select hospitals in Germany and will be available in additional locations in the future. In parallel the DIAMOND system is undergoing positioning clinical studies in several countries in \u00a0Europe and in Hong Kong.\u00a0 The trial in Hong Kong is a comparison study between Diamond and insulin for people with type 2 diabetes.<\/p>\n

Karmel Allison<\/a> contributed to this interview.<\/p>\n

Jessica Apple is the editor-in-chief of ASweetLife.\u00a0 She writes the blog The Natural Diabetic<\/a>.<\/p>\n


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