MetaCure Ushers in a New Era in Interventional Diabetes
Welcome to the new world of interventional diabetes. Based on new data, institutions offering gastric bypass surgeries for weight loss are now recasting them as treatments for type 2 diabetes. This is a dramatic change in perspective within the drug-oriented diabetology world. Now MetaCure hopes to take that interventional notion a step further, with a minimally-invasive and reversible therapy based on electrical stimulation applied to the stomach.
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In early October, EnteroMedics announced the preliminary results of its pivotaltrial on its vagal nerve blocking approach to obesity. The verdict: the study did not meet primary or secondary end points. This was the second neuromodulation company working in obesity (Medtronic was the first) to experience a disappointment in pivotal clinical trials after early results looked so good. Several neurostimulation companies are still targeting obesity. Should their investors be worried? Is this troubling news for the field of neuromodulation at large? Not surprisingly, executives from two neurostimulation companies--IntraPace and Leptos Biomedical--answer the questions simply: no and no.
Researchers have recently discovered that Roux-en-Y gastric bypass surgery is a very effective tool for improving-and sometimes completely reversing-type 2 diabetes. Medtech interviews Francesco Rubino, MD, chief of gastrointestinal metabolic surgery at Cornell University's Weill Cornell Medical College, who is at the forefront of a new subspecialty in bariatric surgery called diabetes surgery. He and his group are studying exactly how bariatric surgery succeeds in reversing type 2 diabetes.
It's not often that a company in the medical device industry, where most new products offer incremental innovation, has a chance to change the world. Start-up GI Dynamics does, though. Shooting for a non-invasive device that would replicate some of the benefits of the invasive Roux-en-Y gastric bypass surgery in obesity, it discovered that an endoscopically delivered implant appears to be extremely effective in type 2 diabetes, as is the predicate gastric bypass. Simple and non-invasive, the technology is potentially disruptive by reversing the disease, not just managing its symptoms. (See also the sidebar to this article: "A Mechanistic Look at Diabetes Surgery: An Interview with Francesco Rubino." )