Endocrine Abstracts

Introduction: We present preliminary results of the treatment with DIAMOND system – novel method of therapy of type 2 diabetes (T2DM) associated with obesity, based on new technology – gastric contractility modulation (GCM).

Material and methods: In 23 overweight/obese patients with T2DM enrolled into the polish arm of the multicenter, prospective, randomized study device modulating gastric contractility was implanted. We present data from nine women and three men aged 41–61 years with BMI 28.1–42.5 kg/m² who completed to date third period of the study. DIAMOND™ system recognize natural electrical activity of the stomach and automatically apply nonexcitatory electrical stimulation treatment during eating with subsequent modulation of signals transmitted by vagus nerve to the regulatory centers in the brain in order to provoke en early response of the gut typical of a full meal. HbA1c, body weight, BMI and waist circumference were observed during the next 72 weeks.

Results: Results of the treatment turned out to be triglyceride-dependent. In group with initially low triglycerides significant decrease in HbA1c, body weight and waist circumference were observed: from 8.28±0.8 to 7.05±0.4, P<0.04; from 88.35±6.14 to 84.3±6.6, P<0.04; and from 111.4±4.8 to 103.7±7.8, P<0.03 respectively. In patients with high triglycerides results were not significant.

Conclusions: DIAMOND™ system is safe, well tolerated, and has significant impact on HbA1c and weight loss. This novel method of treatment addressed for type 2 diabetes patients with overweight/obesity may probably become an alternative to the use of the incretins or insulin. It may also substitute the bariatric surgery in obese patients who are unwilling to undergo vast and anatomically irreversible operation or do not meet all required criteria to justify these procedures. The DIAMOND™ system provide good glycemic control with minimal patient compliance and with a potential added benefit of body weight loss, but without GLP1 mimetics treatment related adverse effects.