A single endoscopic duodenal mucosal resurfacing procedure, coupled with a GLP-1 receptor agonist and lifestyle coaching, might eliminate the need for insulin in most patients with type 2 diabetes, according to the results of a pilot study.

Duodenal mucosal hyperplasia occurs early in diabetes and contributes to insulin resistance.

Revita duodenal mucosal resurfacing, developed by Fractyl Laboratories, which funded the study, is a minimally invasive, outpatient endoscopic procedure that causes hydrothermal ablation, partially removing a layer of the duodenal mucosa.

The procedure has been shown to improve insulin sensitivity and improve glycaemic control in patients with type-2 diabetes.