BACKGROUND: Gastrointestinal electromodulation therapy is a novel alternative for achieving diabetes control without traditional bariatric surgery. We compared the efficacy of a meal-initiated implantable gastric contractility modulation (GCM) device with that of insulin therapy in obese Chinese type 2 diabetes (T2D) patients, for whom oral antidiabetes drugs (OADs) had failed. PATIENTS AND METHODS: Sixteen obese (body mass index, 27.5-40.0 kg/m(2)) T2D patients with a glycated hemoglobin (HbA1c) level of >7.5% on maximal doses of two or more OADs were offered either insulin therapy (n=8) or laparoscopic implantation of a GCM (n=8). We compared changes in body weight, waist circumference (WC), and HbA1c level 1 year after surgery. RESULTS: The GCM and insulin groups had similar baseline body weight and HbA1c. At 12 months, body weight (-3.2±5.2 kg, P=0.043) and WC (-3.8±4.5 cm, P=0.021) fell in the GCM group but not in the insulin group (P<0.05 for between-group difference). At 6 and 12 months, the HbA1c level fell by 1.6±1.1% and 0.9±1.6% (P=0.011), compared with 0.6±0.3% and 0.6±0.3% (P=0.08) for the insulin group (P=0.15 for between-group difference). The mean 24-h systolic blood pressure (BP) fell by 4.5±1.0 mm Hg in the GCM group (P=0.017) but not in the insulin group. The GCM group required fewer antidiabetes medications (P<0.05) and BP-lowering drugs (P<0.05) than the insulin group. A subgroup analysis showed that patients with a triglyceride level of <1.7 mmol/L had a tendency toward a lower HbA1c level (P=0.090) compared with the controls. CONCLUSIONS: In obese T2D patients for whom OADs had failed, GCM implantation was a well-tolerated alternative to insulin therapy, with a low triglyceride level as a possible predictor for glycemic response.
BACKGROUND: Gastrointestinal electromodulation therapy is a novel alternative for achieving diabetes control without traditional bariatric surgery. We compared the efficacy of a meal-initiated implantable gastric contractility modulation (GCM) device with that of insulin therapy in obese Chinese type 2 diabetes (T2D) patients, for whom oral antidiabetes drugs (OADs) had failed. PATIENTS AND METHODS: Sixteen obese (body mass index, 27.5-40.0 kg/m(2)) T2D patients with a glycated hemoglobin (HbA1c) level of >7.5% on maximal doses of two or more OADs were offered either insulin therapy (n=8) or laparoscopic implantation of a GCM (n=8). We compared changes in body weight, waist circumference (WC), and HbA1c level 1 year after surgery. RESULTS: The GCM and insulin groups had similar baseline body weight and HbA1c. At 12 months, body weight (-3.2±5.2 kg, P=0.043) and WC (-3.8±4.5 cm, P=0.021) fell in the GCM group but not in the insulin group (P<0.05 for between-group difference). At 6 and 12 months, the HbA1c level fell by 1.6±1.1% and 0.9±1.6% (P=0.011), compared with 0.6±0.3% and 0.6±0.3% (P=0.08) for the insulin group (P=0.15 for between-group difference). The mean 24-h systolic blood pressure (BP) fell by 4.5±1.0 mm Hg in the GCM group (P=0.017) but not in the insulin group. The GCM group required fewer antidiabetes medications (P<0.05) and BP-lowering drugs (P<0.05) than the insulin group. A subgroup analysis showed that patients with a triglyceride level of <1.7 mmol/L had a tendency toward a lower HbA1c level (P=0.090) compared with the controls. CONCLUSIONS: In obese T2Dpatients for whom OADs had failed, GCM implantation was a well-tolerated alternative to insulin therapy, with a low triglyceride level as a possible predictor for glycemic response.
Authors: Claudia P Sanmiguel; Jeffrey L Conklin; Scott A Cunneen; Philip Barnett; Edward H Phillips; Mark Kipnes; John Pilcher; Edy E Soffer Journal: J Diabetes Sci Technol Date: 2009-07-01
Authors: Rena R Wing; Paula Bolin; Frederick L Brancati; George A Bray; Jeanne M Clark; Mace Coday; Richard S Crow; Jeffrey M Curtis; Caitlin M Egan; Mark A Espeland; Mary Evans; John P Foreyt; Siran Ghazarian; Edward W Gregg; Barbara Harrison; Helen P Hazuda; James O Hill; Edward S Horton; Van S Hubbard; John M Jakicic; Robert W Jeffery; Karen C Johnson; Steven E Kahn; Abbas E Kitabchi; William C Knowler; Cora E Lewis; Barbara J Maschak-Carey; Maria G Montez; Anne Murillo; David M Nathan; Jennifer Patricio; Anne Peters; Xavier Pi-Sunyer; Henry Pownall; David Reboussin; Judith G Regensteiner; Amy D Rickman; Donna H Ryan; Monika Safford; Thomas A Wadden; Lynne E Wagenknecht; Delia S West; David F Williamson; Susan Z Yanovski Journal: N Engl J Med Date: 2013-06-24 Impact factor: 91.245
Authors: Simon K H Wong; Alice P S Kong; Wilfred L M Mui; W Y So; Bonnie Y S Tsung; Phyllis Y P Yau; Francis C C Chow; Enders K W Ng Journal: Hong Kong Med J Date: 2009-04 Impact factor: 2.227
Authors: Xavier Pi-Sunyer; George Blackburn; Frederick L Brancati; George A Bray; Renee Bright; Jeanne M Clark; Jeffrey M Curtis; Mark A Espeland; John P Foreyt; Kathryn Graves; Steven M Haffner; Barbara Harrison; James O Hill; Edward S Horton; John Jakicic; Robert W Jeffery; Karen C Johnson; Steven Kahn; David E Kelley; Abbas E Kitabchi; William C Knowler; Cora E Lewis; Barbara J Maschak-Carey; Brenda Montgomery; David M Nathan; Jennifer Patricio; Anne Peters; J Bruce Redmon; Rebecca S Reeves; Donna H Ryan; Monika Safford; Brent Van Dorsten; Thomas A Wadden; Lynne Wagenknecht; Jacqueline Wesche-Thobaben; Rena R Wing; Susan Z Yanovski Journal: Diabetes Care Date: 2007-03-15 Impact factor: 19.112