duodenal mucosal resurfacing in treating T2

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duodenal mucosal resurfacing in treating T2


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Old 10-14-2020, 01:58   #1
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Default duodenal mucosal resurfacing in treating T2

I recently came across an article in the news discussing duodenal mucosal resurfacing. This is a surgical procedure that removes mucosal cells from the surface of the duodenum (the first part of the large intestine). This, in turn, causes the body to grow new mucosal cells.

These new cells apparently manage and regulate insulin use properly. Of those who completed the study, 75 percent of those who had been managing their T2 with insulin could stop using insulin and still did not need it six months later. They also lowered their BMI (body mass index) and lowered by half the percentage of fat in their livers.

Another study is being launched, this time involving American volunteers (who apparently already have been selected...). A couple of studies I've seen indicated that long-term liver effects should be studied further; I also read conflicting reports of who is best suited to this mode of treatment.

You can read the specifics of the study and results at https://pubmed.ncbi.nlm.nih.gov/32952067/

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Old 10-14-2020, 15:48   #2
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Interesting, gonna have to look more at the other related articles.

Wonder if there is a comparison on the duodenum mucosal cells of a T2 and a non-T2.

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Old 10-14-2020, 16:56   #3
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Quote:
Originally Posted by mbuster View Post
Wonder if there is a comparison on the duodenum mucosal cells of a T2 and a non-T2.
I did not see such a link. Presumably the issue is that the T2s have enough insulin; it's just not managed properly. T1s often don't have sufficient insulin production regardless of how it would be regulated.

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Old 10-14-2020, 22:23   #4
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Maybe I said it wrong, difference between a type 2 and a non-diabetic. I wonder if something in the cells change and makes us diabetic?

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Old 10-14-2020, 23:28   #5
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Ah! Good question! I'll have to see what I can find out about why this works -- are the duodenal cells deficient or damaged from birth or by some trauma or whether it has to do with other factors associated with insulin resistance. I'll report back tomorrow with what I find.

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Old 10-18-2020, 16:33   #6
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...and apologies for getting back on this so late (life...).

Anyway, in reading more studies, it appears that people with diabetes (T1 or T2, and, presumably, other types) have a characteristic pattern of inflammation in their duodenal mucosa. This is related to the presence of specific bacteria in the stomach (and, therefore, the duodenum) of diabetics.

Gut biome bacteria (good and bad) apparently are characteristic but different in diabetics, non-diabetics, people with celiac disease, people with colitis, etc., with research indicating that changes in the gut biome (either introduced from outside the body through probiotics or through mechanisms like DNR) can have a generally positive effect, all the way up to remission of the condition. For most conditions, though, it is difficult to create a "recipe" that acts as a remedy because there is not a complete understanding of the presence or interplay of these bacteria.

There have been studies of the gut biomes of T1s, as well. Their duodenums also show inflammation. I did not see a study comparing the expressions of that inflammation to see if they were similar to those of T2s.

However, I did see a study that showed that enteroviruses were quite disruptive to the pancreas and gut of both T1s and T2s, either invoking or a consequence of the body's autoimmune process. And, apparently, the presence of the virus over the long haul (sounds familiar in discussion of COVID-19?) may have an effect on whether someone develops T1 or T2 -- or neither.

It also is possible that poor insulin regulation/chronic hyperglycemia is a contributing factor to the severity and persistence of enteroviral infections (something said about diabetes being a risk factor for COVID-19). Kind of a chicken-or-egg thing...

I don't want to conflate COVID-19 with diabetes, though, other than to point out that the body's reaction to various kinds of viruses may have a bearing on the development of diabetes -- and/or any one of dozens of other diseases -- and that the presence of diabetes may increase the risk of developing other illnesses.

There also has been a call for studies examining the role of endocrine-disrupting chemicals such as PCBs, BPA, and phthalates in an individual's chances of developing diabetes.

In addition, gut mucosa may be an important reservoir from which viruses can spread to the pancreas, which is very close to the gut in the body and which shares lymphatic and blood vessel networks.

So the tl;dr: it is not clear exactly how T1 develops, which makes it difficult to determine the role of gut bacteria and mucosal ablation in treating it.

Here are a couple of the studies I saw which I believe would serve as a good jumping-off point for someone interesed in looking further at this. Warning: it can become an occupation!

https://academic.oup.com/jcem/articl...5/1468/2926660

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282798/

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