Sa1962 DUODENAL MUCOSAL RESURFACING (DMR) COMBINED WITH GLP-1 RECEPTOR AGONISM MAY ELIMINATE INSULIN TREATMENT WHILE MAINTAINING GLYCAEMIC CONTROL AND IMPROVING OVERALL METABOLIC HEALTH IN TYPE 2 DIABETES

Systemic hyperinsulinemia, resulting from background insulin resistance and exogenously administered insulin, contributes to impaired metabolic health in many patients with type 2 diabetes (T2D). Altered metabolic signaling from the gut is thought to play a pathophysiological role in T2D. Duodenal Mucosal Resurfacing (DMR) is an endoscopic procedure that administers hydrothermal ablation to the duodenum. It has been shown to improve glycaemic control and insulin sensitivity in T2D patients on oral glucose lowering medication. Our study assesses feasibility and efficacy of halting daily insulin therapy in insulin treated T2D patients and instead treating with a combination of single DMR, GLP-1r agonism (liraglutide) and lifestyle counseling. This might lead to a more physiological metabolic control of T2D without the need for exogenous insulin therapy.