Een maagpacemaker bij patiënten met obesitas en diabetes mellitus type 2

The combination of obesity and type 2 diabetes mellitus forms a growing global epidemic. The primary treatment for patients with this combination of conditions is to advise them to adopt a healthier lifestyle, but only a few patients succeed in doing this. Patients with type 2 diabetes who have to switch to insulin treatment can experience negative consequences, such as weight gain and an increased risk of hypoglycaemia. An alternative treatment that does not have these adverse effects is a gastric pacemaker, which can be implanted via laparoscopy: the patients lose weight and show an improvement in glucose regulation. The gastric pacemaker uses non-excitatory stimulation to influence the amplitude of gastric contraction. It simultaneously stimulates afferent fibres of the vagal nerve to influence the cerebral satiation centre, which is involved in registration of satiety and in insulin secretion and resistance. A randomized trial on the effects of the gastric pacemaker in patients with obesity and type 2 diabetes mellitus is currently being conducted in the Atrium Medical Centre in Heerlen.

Conflict of interest and financial support: a disclosure form provided by the author is available along with the full text of this article at www.ntvg.nl; search for A5929, click on ‘Belangenverstrengeling’ (‘Conflict of interest’).