The majority of patients with type 2 diabetes (T2D) begin treatment with an oral antihyperglycemic medication. While initially most patients can control glucose levels with a single drug, ultimately patients will need to adopt a more complicated treatment, as diabetes is a progressive condition with deterioration of B cell function over time. Combination oral drug regimens are common but, even with two or more antihyperglycemic drugs, a patient may not be able to achieve target glycemic (HbA1c) goals.1
Newer therapies, both oral and injectable, have entered the T2D treatment arsenal in recent years. The newer oral medications are not as effective as insulin in lowering HbA1c. Injectable GLP-1 receptor agonists do have similar efficacy as insulin but have side effects (e.g., vomiting, diarrhea) that many patients cannot tolerate.2
In addition, bariatric surgery is an increasingly used treatment for obese T2D patients. There are many bariatric options, which range from open gastric bypass surgery to minimally invasive implantation of a device that restricts the stomach. Some surgeries carry a high risk, have technical complexity, and involve a permanent alteration to the anatomy. Many require a later revision to the surgery, and most entail adjustments to diet and lifestyle.
Within this trend for interventional solutions, a promising new treatment—gastric contractility modulation (GCM)—has been shown to be effective in lowering HbA1c and weight with minimal, tolerable, side effects. GCM could surmount the deficits in current diabetes pharmaceutical therapies, namely unwanted complications and side effects, treatment complexity, and suboptimal patient adherence. Compared to interventional treatments, GCM requires a single, minimally invasive and fully reversible procedure that retains the native anatomy. GCM leverages the normal processes within the body for processing nutrients and controlling after-meal glucose levels.3
The DIAMOND System, an implantable device therapy composed of a rechargeable pulse generator and three pairs of bi-polar electrodes, applies GCM to the treatment of T2D. Through meal-mediated non-excitatory stimulation, DIAMOND restores the physiological synchronization between food intake and natural hormone secretion, lowering post-prandial glucose levels. DIAMOND involves a one-time minimally invasive laparoscopic procedure.
Clinical trials of DIAMOND have demonstrated significant sustained HbA1c reduction, weight loss, and improvement in blood pressure at three-year follow up.4 Notably, DIAMOND has been shown to be as effective as insulin in lowering HbA1c.5 DIAMOND is well tolerated by patients, and the minimal side effects (mainly post-operative pain) are transient.6,7
Compared to oral T2D therapies, DIAMOND could offer superior glycemic reduction, a better side effect profile, and improved overall health based on DIAMOND’s positive effect on weight and blood pressure. DIAMOND may be a preferable option compared to treatment escalation with insulin, which requires frequent monitoring and is associated with hypoglycemia, weight gain, and suboptimal patient adherence.8,9 DIAMOND also has a favorable profile relative to bariatric surgeries, with similar efficacy as the gold standard interventional treatment, gastric bypass, but without the risks, post-surgical complications or dietary and lifestyle restrictions.
The prevalence of T2D is expected to increase dramatically over the next 15-20 years, as a consequence of the worldwide obesity epidemic.10,11 It’s clear that the medical community is increasingly open to interventional treatments for these patients because of the weight gain and hypoglycemia associated with insulin and the undesirable side effects of other injectable therapies. Given the advantages of GCM compared to other interventional treatments, DIAMOND is uniquely positioned to become a preferred T2D treatment for the future: A one-time, minimally invasive intervention with a meaningful reduction in HbA1c, minimal side effects, and limited resource consumption.