Efficacy of Photothermal Duodenal Mucosal Ablation (PDMA) on Glycemic Control in a Type 2 Diabetic Rat Model

The current study aims to evaluate the efficacy and safety of photothermal duodenal mucosal ablation (PDMA), utilizing a 1470 nm wavelength and a diffusing fiber (DF), in ex vivo liver tissues and an in vivo type 2 diabetes mellitus (T2DM) rat model. The 1470 nm laser with the DF was used for uniform duodenal mucosal ablation. After optimizing dosimetry (9–49 J) ex vivo, PDMA was performed on twelve T2DM rats (n = 4 per group) induced by a high-fat diet and streptozotocin. Glycemic metabolism and histological changes were monitored for 14 days. All experimental data were analyzed using the Mann–Whitney U test for statistical significance. Optimized PDMA (5 W for 5 s) achieved uniform, circumferential mucosal ablation while preserving outer layers. Histology assessment confirmed optimal ablation at day 2 with substantial regeneration by day 14. Consequently, the PDMA group showed significantly improved glycemic indexes at day 14 compared to the sham control. Therefore, the proposed PDMA may be promising in remodeling the duodenal mucosa for glycemic control in T2DM. Future research will evaluate the PDMA in a larger number of animals to warrant efficacy and safety for clinical translation.