How Endoscopic Sleeve Gastroplasty Can Treat Type 2 Diabetes

Dr. Christopher McGowan
April 4, 2024

ESG and Lifestyle Changes Can Help Reverse Type 2 Diabetes

Type 2 diabetes is a serious chronic condition that affects your metabolism and ability to convert glucose from the food you eat into the energy that powers your body on a cellular level. It’s commonly associated with obesity, and weight loss is a key component of treatment.

Over 100 million Americans have been diagnosed with type 2 diabetes or its precursor, prediabetes. Though the disease can’t be cured, it can often be prevented through healthy lifestyle choices. What’s more, significant weight loss can lead to remission, defined as maintaining normal, non-elevated blood sugar levels for six months or more.  

Significant weight loss is often the first step in regaining blood sugar control and improving diabetes-related health indicators.

Endoscopic sleeve gastroplasty, also called ESG, is a highly-advanced, minimally invasive weight loss procedure for people who want to treat their type 2 diabetes without surgery. It can accelerate weight loss, reverse insulin resistance, and lower blood sugar.

What is Type 2 Diabetes?

Diabetes mellitus is a group of diseases that impact how the body uses glucose (blood sugar) to power cells. Blood sugar is a critical source of energy for the brain, as well as muscular and tissue cells throughout the body. Too much glucose in the blood, however, can damage blood vessels throughout the body, leading to nerve, kidney, eye, heart, and brain diseases, including dementia and depression.

There are three types of diabetes:

  • Type 1, sometimes called juvenile or insulin-dependent diabetes, accounts for only 5 to 10 percent of cases and is thought to be caused by an autoimmune problem which attacks insulin production in the pancreas.
  • Type 2, the most common type of diabetes, is associated with lifestyle factors, including poor diet, obesity, and lack of physical activity.
  • Gestational diabetes is a fairly rare form of diabetes that develops in pregnancy and, if left untreated, can create complications for the growing fetus. It is usually temporary, disappearing after pregnancy, but may point to an elevated risk of developing type 2 diabetes in the future.

Type 2 diabetes is specifically related to obesity -- a chronic, progressive, multi-factor disease that correlates closely with many other metabolic disorders, including high blood pressure, high cholesterol, and increased risk for heart attack and stroke. Uncontrolled blood sugar can also lead to kidney disease, nerve damage, and vision loss.

Why is Weight Loss Important for Diabetes Treatment?

Weight loss is a key component of treatment for type 2 diabetes. Significant weight loss can reduce blood sugar levels into a non-diabetic range; if a person stays in that non-diabetic range for six months or more, physicians consider their diabetes to be in remission. The problem is that studies show over and over that significant weight loss is very difficult to achieve through lifestyle changes alone, and that many people who lose weight through diet and exercise have a hard time keeping it off.

That’s where weight loss procedures can offer significant benefits for patients seeking a long-term, sustainable solution for managing both their obesity and related conditions, including type 2 diabetes.

Can ESG Help Treat Type 2 Diabetes?

Endoscopic sleeve gastroplasty (also known as ESG) is an innovative, non-surgical weight loss procedure that helps patients lose up to 20 percent of their body weight. Comparable to traditional bariatric surgery, ESG is extremely effective for weight loss, reducing the size of a patient’s stomach by 70 to 80 percent, so they become full more quickly, eat fewer calories, and lose weight rapidly and sustainably. Unlike surgery, ESG is an outpatient procedure requiring minimal downtime, no external incisions, and carries an exceedingly low risk of complications.

In an ESG procedure, an expert physician specializing in gastroenterology and obesity medicine inserts a flexible tube (called an endoscope) down your throat and into your stomach. The endoscope is fitted with a suturing device that allows a gastroenterologist to place stitches in the stomach to reduce its size. The procedure usually takes less than 45 minutes and requires 7 to 12 sutures. Most people go home the same day and can return to their normal routine in less than a week.

Endoscopic sleeve gastroplasty is a good option for people:

  • With a body mass index (BMI) of 30 or higher;
  • Who have not succeeded with diet and exercise alone;
  • Who do not qualify for or desire traditional bariatric surgery; and
  • Are ready to commit to lifestyle changes to support long-term success.

Studies show that ESG is an excellent treatment option for people with class 1 and class 2 obesity, defined as a body mass index (BMI) of 30 to 35, or 35 to 40, respectively. More research is needed on patients with class 3 obesity (BMI over 40), but in a recent study led by Dr. Daniel Maselli of True You Weight Loss, patients lost 10 percent of their total body weight at 12 months in 96 percent of cases, and 20 percent of their body weight in 55 percent of cases. More than half of the study participants also saw significant improvement in type 2 diabetes and hypertension.

Choosing True You for ESG

Endoscopic sleeve gastroplasty is a complex and highly technical procedure requiring specialized skills, precision, and experience. Choosing True You Weight Loss for your ESG procedure means you’re getting:

  • Unrivaled expertise: True You Weight Loss is the highest volume bariatric endoscopy weight loss center in the United States, with three highly qualified physicians who are triple board-certified in internal medicine, gastroenterology, and obesity medicine. Dr. Lauren Donnangelo, Dr. Daniel Maselli, and Dr. Christopher McGowan are recognized leaders in endoscopic weight loss procedures, delivering excellent outcomes and long-term success for patients from 45 states and 10 countries.
  • Lifelong support: For sustainable, long-term success in keeping excess weight off for good, patients need personalized and ongoing support. We offer follow-up, guidance, motivation, and encouragement at every step of your journey, celebrating victories on and off the scale, for as long as you need.
  • 24/7 Physician Access: True You Weight Loss offers the highest level of concierge care and service before and after your weight loss procedure. All patients are provided with 24/7 direct access to their physician through email, phone, and video chat.

If you’d like to learn more about ESG at True You Weight Loss, please contact us to request a consultation.

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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