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Gastric Contractility Modulation — a novel method for the treatment of type 2 diabetes mellitus and obesity
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Abstract
Because the majority of antidiabetic medications are of limited efficacy and patient compliance with treatment is usually poor, new therapies are still being searched for. In the review a newly developed system for treatment of subjects with type 2 diabetes and concomitant overweight/obesity is described.
The system consists of an implantable pulse generator that delivers electrical stimuli through leads implanted in the sero-muscular layer of the stomach. The device recognises and automatically modulates natural electrical activity of the stomach during meals, strengthening gastric contractility. This increase in the force of contractions enhances vagal afferent activity. Modulated signals are transmitted to the regulatory centres in the brain in order to provoke an early response of the gut typical of a full meal. Clinical trials performed to date show that the system improves glycaemic control with minimal patient compliance needed and with added benefits of body weight loss, a decrease in blood pressure, and favourable changes in the lipid profile. The system is safe, well-tolerated, with a low risk of hypoglycaemia, and will probably become an alternative to the use of incretins or to bariatric surgery in obese patients who are unwilling to undergo a major and anatomically irreversible operation.
Abstract
Because the majority of antidiabetic medications are of limited efficacy and patient compliance with treatment is usually poor, new therapies are still being searched for. In the review a newly developed system for treatment of subjects with type 2 diabetes and concomitant overweight/obesity is described.
The system consists of an implantable pulse generator that delivers electrical stimuli through leads implanted in the sero-muscular layer of the stomach. The device recognises and automatically modulates natural electrical activity of the stomach during meals, strengthening gastric contractility. This increase in the force of contractions enhances vagal afferent activity. Modulated signals are transmitted to the regulatory centres in the brain in order to provoke an early response of the gut typical of a full meal. Clinical trials performed to date show that the system improves glycaemic control with minimal patient compliance needed and with added benefits of body weight loss, a decrease in blood pressure, and favourable changes in the lipid profile. The system is safe, well-tolerated, with a low risk of hypoglycaemia, and will probably become an alternative to the use of incretins or to bariatric surgery in obese patients who are unwilling to undergo a major and anatomically irreversible operation.
Keywords
interventional diabetology, gastric electrical stimulation, type 2 diabetes, obesity, appetite regulation
About this articleTitle
Gastric Contractility Modulation — a novel method for the treatment of type 2 diabetes mellitus and obesity
Journal
Issue
Article type
Review paper
Pages
579-584
Published online
2017-11-03
Page views
2719
Article views/downloads
2458
DOI
Pubmed
Bibliographic record
Endokrynol Pol 2017;68(5):579-584.
Keywords
interventional diabetology
gastric electrical stimulation
type 2 diabetes
obesity
appetite regulation
Authors
Jarosław Kozakowski
Harold E. Lebovitz
Wojciech Zgliczyński
Wiesław Tarnowski
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