New, less invasive, endoscopic treatments offer promise in weight and diabetes management.Richard I. Rothstein, MD
Obesity is the leading risk factor for Type 2 diabetes, making it a concern for an ever increasing number of Americans. As risk factors for many chronic, potentially life-threatening conditions, diabetes and obesity are also significant concerns for healthcare systems.
New research being conducted at Dartmouth-Hitchcock Medical Center (DHMC) may offer the promise of effective treatment for diabetes that would improve patient health was well as reduce reliance on medication. Richard I. Rothstein, MD, chair of the Department of Medicine at DHMC and a gastroenterologist/hepatologist, is investigating an endoscopic treatment that thins the lining of the first portion of the small intestine— called the duodenum—which has been shown to reduce the amount of medications needed to treat diabetes in 300 patients who underwent the procedure in a small pilot study in Europe.
“A surgical procedure (bariatric) can result in weight loss, and while an excellent option, only about one percent of patients with obesity have that treatment each year and, unfortunately, some patients experience weight regain after several years,” Rothstein said. “New, less invasive, endoscopic treatments offer promise in weight and diabetes management.”
An effective, non-surgical procedure that eliminates the need for insulin injection—or could lower the need for drugs to maintain blood sugars—would offer significant benefits to the over 30 million Americans with Type 2 diabetes and the healthcare systems that treat them. Should it eventually prove helpful for the 90 million Americans classified as prediabetic, the impact could be even greater.
“It would be really rewarding to treat pre-diabetes and diabetes with endoscopy,” Rothstein said. “Can it take patients off insulin? That’s really important to patients with Type 2 diabetes.”
This study is currently recruiting participants. Adults with Type 2 diabetes using insulin who are interested in participating in the study should contact Debbie Larrimore, RN, of the DHMC Gastroenterology Research Team at 603-653-3651.
DARTMOUTH-HITCHCOCK HEALTH (D-HH), New Hampshire’s only academic health system and the state’s largest private employer, serves a population of 1.9 million across Northern New England. D-H provides access to more than 2,400 providers in almost every area of medicine, delivering care at its flagship hospital, Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, NH. DHMC was named in 2019 as the #1 hospital in New Hampshire by U.S. News & World Report, and recognized for high performance in 13 clinical specialties and procedures. Dartmouth-Hitchcock Health also includes the Norris Cotton Cancer Center, one of only 51 NCI-designated Comprehensive Cancer Centers in the nation; the Children's Hospital at Dartmouth-Hitchcock, the state’s only children’s hospital; affiliated member hospitals in Lebanon, Keene, and New London, NH, and Windsor, VT, and Visiting Nurse and Hospice for Vermont and New Hampshire; and 24 Dartmouth-Hitchcock clinics that provide ambulatory services across New Hampshire and Vermont. The D-H system trains nearly 400 residents and fellows annually, and performs world-class research, in partnership with the Geisel School of Medicine at Dartmouth and the White River Junction VA Medical Center in White River Junction, VT.