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Review
. 2021 Nov;70(11):2196-2204.
doi: 10.1136/gutjnl-2020-323931. Epub 2021 Sep 8.

Alternative treatments for type 2 diabetes and associated metabolic diseases: medical therapy or endoscopic duodenal mucosal remodelling?

Annieke C G van Baar #  1 , Suzanne Meiring #  1 , Frits Holleman  2 , David Hopkins  3 , Geltrude Mingrone  4   5 , Jacques Devière  6 , Max Nieuwdorp  7 , Jacques J G H M Bergman  8
Affiliations
Review

Alternative treatments for type 2 diabetes and associated metabolic diseases: medical therapy or endoscopic duodenal mucosal remodelling?

Annieke C G van Baar et al. Gut. 2021 Nov.
No abstract available

Keywords: diabetes mellitus; duodenal mucosa; fatty liver; gastrointestinal endoscopy; glucose metabolism.

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Conflict of interest statement

Competing interests: MN is in the Scientific Advisory Board of Caelus Pharmaceuticals, The Netherlands, and Kaleido Biosciences, USA. None of these is directly relevant to the current paper. DH has received honoraria from Fractyl for participating in scientific advisory boards. There are no patents, products in development or marketed products to declare. The other authors declare no competing financial interests.

Figures

Figure 1
Figure 1
Complex metabolic changes induced by bariatric surgery and interventions involving the duodenum. Inspiration for this figure came from Madsbad et al. FGF-19, fibroblast growth factor 19.
Figure 2
Figure 2
Illustrations with corresponding endoscopic views during the duodenal mucosal resurfacing (DMR) procedure: (A and B) introduction of the DMR catheter into the postpapillary duodenum; (C) submucosal lift and mucosal ablation; (D) postablation endoscopic view; (E and F) circumferentially ablated duodenal mucosa. Illustrations provided by Fractyl Laboratories.
Figure 3
Figure 3
Proposed algorithm of where duodenal mucosal remodelling might fit in the current management of T2D. DPP-4i, dipeptidyl peptidase-4 inhibitor; GLP-1RA, glucagon-like peptide-1 receptor agonist; HbA1c, haemoglobin A1c; SGLT2i, sodium-glucose cotransporter 2 inhibitor; SU, sulfonylurea derivative; T2D, type 2 diabetes.
See this image and copyright information in PMC

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