Improvement in Glycemic Control in Morbidly Obese Type 2 Diabetic Subjects by Gastric Stimulation
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Gastric electrical stimulation synchronized to the refractory period of gastric electrical activity and applied during meals was evaluated for safety and for improvement of body weight and glycemic control in obese type 2 diabetes.
The study involved obese diabetic type 2 (ODM) patients in a multicenter open-label European feasibility trial. A total of 24 ODM (nine males, 15 females) treated with insulin and/or oral hyperglycemic agents and body mass index between 33.3 to 49.7 kg/m2 were implanted laparoscopically with a TANTALUS system.
There were 18 adverse events related to the implant procedure or the device reported in 12 subjects. All were short lived and resolved with no sequelae. In the 21 subjects that reached the 1-year visit weight was reduced by 4.5 ± 2.7 kg (p < 0.05) and HbA1c by 0.5 ± 0.3% (p < 0.05). In a subgroup (n = 11) on stable or reduced oral medication, weight was reduced by 6.3 ± 3.4 kg (p < 0.05) and HbA1c by 0.9 ± 0.4% (p < 0.05). The group on insulin (n = 6) had no significant changes in weight and HbA1c.
The TANTALUS system is well tolerated in obese type 2 diabetic subjects. Gastric electrical stimulation can potentially improve glucose metabolism and induce weight loss in obese diabetic patients, who are not well controlled on oral antidiabetic therapy. Further evaluation is required to determine whether this effect is due to induced weight loss and/or to direct signal dependent mechanisms.
KeywordsGastric pacemaker Gastric stimulation Laparoscopy Weight loss Gastric contractility modulation Glycemic control
Excess weight loss
Three-Factor Eating Questionnaire
Body mass index
Gastric contractility modulation
Fasting blood glucose
This work was supported by a research grant from MetaCure (USA) Inc, Orangeburg, NY. TANTALUS™ system is a registered trademark of MetaCure NV, Inc.
- 18.Dockray GJ. The brain-gut axis. In: Yamada T, editor. Basic mechanisms of normal and abnormal gastrointestinal function. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2003. p. 77–91.Google Scholar