Gastric stimulation in treatment in type 2 diabetes mellitus.
Metabolic surgery is a dynamic field providing a wide range of new techniques. The aim of our paper is to inform about gastric electrostimulation in the treatment of type 2 diabetes mellitus. Gastric electrostimulation in type 2 diabetes mellitus treatment is performed by means of implanting Tantalus system (Metacure). When triggered by food intake, the Tantalus system generates signals for the stomach to contract. Early after the food intake, thus before the stomach distends completely, the system increases spontaneous stomach contractions. Via afferent vagal signals, these increased contractions are evaluated by the central nervous system as a sign that satiety has been reached. Three pairs of electrodes connected with a stimulator are implanted laparoscopically. The system comes equipped with a battery as well. Laparoscopically implanted system of stomach electrostimulation presents a simple and easily regulated system without disturbing the integrity of gastrointestinal tract. It is a reversible system. In accord with preliminary results, Tantalus offers a safe and effective treatment of type 2 diabetes mellitus by reducing other cardiometabolical risky factors. The operation safety is comparable with that of similar minimally invasive surgical techniques. In order to improve our understanding of diabetes mellitus pathophysiology as well as of effects of gastric electrostimulation, more trials need to be performed. The surgical diabetes treatment represents an interesting chance for patients and it might become a common technique in the future (Fig. 1, Ref. 29).


BACKGROUND
diabetes mellitus, obesity, gastric stimulation, pacemaker.
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Zonca
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Hoppe
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Cambal
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Jacobi
D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods; D004567:Electrodes, Implanted; D005746:Gastric Emptying; D006801:Humans; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D013270:Stomach / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss