Duodenal Mucosal Resurfacing (DMR)

Duodenal Mucosal Resurfacing (DMR) is a minimally invasive endoscopic procedure that uses heat to renew the lining of the small intestine. By replacing the damaged surface of the duodenum with healthy new cells, it can improve the bodys hormonal response to food and help control blood sugar. DMR is being studied as a treatment option for type 2 diabetes, especially in patients who also have weight management concerns.

Duodenal Mucosal Resurfacing is an endoscopic procedure that applies thermal energy (hydrothermal ablation) to selectively ablate the hyperplastic duodenal mucosa. The regenerated mucosa is believed to restore normal enteroendocrine signalling, including GLP-1 and GIP secretion, improving insulin sensitivity independent of weight loss. The procedure lasts approximately 60 minutes and is performed under deep sedation using a specialised balloon catheter inserted through an endoscope.

DMR represents a novel procedural approach to metabolic disease that works on the gut hormone axis rather than restriction or malabsorption. For patients with type 2 diabetes struggling with weight, it offers a less invasive alternative to conventional bariatric surgery with a shorter recovery time and fewer anatomical alterations.