Aoki Diabetes Research Institute
Celebrating our 28th year of research and improved outcomes.
1. Are there other names sometimes used for MAT® treatment
In research reports the therapy was called by several different names. At first it was called hepatic activation because it improves liver metabolism. Later it was called metabolic activation therapy because it improves metabolism not just in the liver, but also in many other tissues. Sometimes descriptive names have been used such as chronic intermittent intravenous insulin therapy or pulsatile intravenous insulin therapy, or intensive insulin therapy. At times, companies with no rights to the therapy have attempted to sell it using other names, confusing investors and patients.
2. When is MAT® treatment recommended?
At this time, MAT® treatment is recommended when patients are unable to achieve good glucose control because of severe hypoglycemic episodes due to hypoglycemia unawareness, and/or when diabetic complications are occurring despite vigorous attempts at strict glucose control by the patient and endocrinologist.
The addition of MAT® treatment to the American Diabetes Association recommended treatment program can reduce hypoglycemic attacks (dangerously low blood sugar) by improving hypoglycemia unawareness and can reduce or delay many complications of diabetes such as damage to kidneys and eyes, abnormal blood pressure, painful neuropathy of the feet and legs, gastroparesis, and foot ulcers.
3. What is a MAT® treatment weekly treatment session?
For a 6-
4. Why does the MAT® treatment need to be done weekly?
Because the metabolic improvements resulting from a 6-
5. How soon does improvement occur with MAT® treatments?
With each 6-
6. What happens in-
During the week between the 6-
7. How do MAT® treatments work?
A MAT® treatment involves delivering insulin intravenously in a pulsatile fashion
using a special pump over a 6-
This improved metabolism is measured by the patient's respiratory quotient (RQ).
RQ is a measure of the success of tissues in using oxygen and burning fuel. During
Over many months glucose metabolism returns to a more normal pattern and is maintained there by weekly MAT® treatments. The metabolism of many other tissues also improves, permitting more normal glucose control, more normal blood pressure control, and the repair of some complications of diabetes.
8. Why can't an insulin pump or other insulin produce the same improvements that are seen with MAT® treatment?
Insulin shots or insulin pumps that inject insulin subcutaneously (under the skin) have two drawbacks"
1) they provide lower-
2) they can only gradually increase or decrease in the concentration of insulin.
In short, insulin pumps and insulin subcutaneous injections can not produce the high-
Because MAT® treatment involves injecting insulin intravenously (IV), it raises the
insulin level to the liver to a normal range and because it delivers pulses of insulin
it closely mimics the high-
Note: IV insulin must only be given under a doctor's care because it can rapidly decrease blood sugar to dangerously low levels. MAT® treatment is done under a doctor's supervision, with close monitoring, and includes glucose administration in planned amounts.
9. Why are MAT® treatments recommended as a long term continuing program?
If weekly MAT® treatments are stopped for any reason, all the improvements that were seen on the therapy are gradually lost and complications return and progress.
Patients continuing on the therapy can stabilize their complications for years, thus avoiding progression to kidney failure for example. This is in marked contrast to the usual course of diabetic complications which is a relentless progressive loss of function.
10. List some of the benefits patient's have reported with MAT® treatment
11. Does every patient with diabetes need MAT® treatment?
No. MAT® treatment is usually recommended only for patients with diabetes who, despite carefully following ADA or AACE recommended therapy (or treatment by an Endocrinologist), continue to have serious problems with glucose control or diabetic complications. Most of these patients have Type 1 diabetes, but some have Type 2.
13. Why can't I try MAT® treatment at home myself?
Just reading this website does not give enough information on how to do MAT® treatment to allow you to safely try it at home. MAT® treatment is a complex patented methodology done under a doctor's care. Do NOT try to imitate MAT® treatments at home. Insulin should not be given intravenously without a doctor's supervision. Insulin can cause severe disability, coma, and death.
14. How much does MAT® treatment cost?
The cost for one patient for MAT® treatment is approximately $25,000 per year. This is in addition to a patient's usual medical bills. MAT® treatment is not an experimental procedure but it is not covered by many medical insurance companies. Medicare and Medicaid will not pay for MAT® treatment. It is not possible to appeal this, because there was a National Coverage Determination in 2009. In some cases, insurers such as Medicare have paid initially and then later demanded their money back. (See Medicare)
The insurance companies refusal to pay for MAT® treatment is surprising because
for some seriously ill patients MAT® treatment has not only improved quality of
life, it has also been cost-
15. How does metabolic function improve with MAT® treatment
In contrast to usual insulin therapy, MAT® insulin pulses imitate the body's own
natural insulin release patterns and appear to enhance the liver's ability to store,
mobilize and utilize glucose. The higher level of insulin available to the liver
with MAT® treatment stimulates liver cells to synthesize glucokinase and other insulin-
Comparison of actions of MAT® treatment with subcutaneous insulin
16. What are MAT® treatment's effects on the liver?
The pulses of high dose insulin seen by the liver during MAT® treatments are very
similar to those of the first phase of pancreatic insulin secretion in non-
MAT® treatment apparently restores glucose homeostasis by increasing the production and activity of glucokinase in the liver and other tissues.
Glycogen Storage and Glucose oxidation.
MAT® treatment has been shown to improve glycogen storage and glucose oxidation by the liver, a function of enhanced liver enzyme activity. Increased glycogen storage and glucose oxidation helps normalize blood glucose by preventing wide "swings" or rapid hypoglycemia.
MAT® treatment produces a more normal respiratory quotient due to more efficient oxidation of fuels by the liver and other tissues. In both normal and diabetic individuals, most organs, e.g. muscle, heart, skin, rely on the metabolism of fatty acids for 70 percent to 80 percent of their fuel. However, the breakdown of fatty acids requires more oxygen at the cellular level than the breakdown of glucose for a given energy output. Pulsed insulin therapy may permit these organs to use glucose as an energy source to a significantly greater extent than usual (due to increased pyruvate dehydrogenase activity) and thus decrease the organ's oxygen requirements.
At times of reduced tissue oxygen, such as when circulation is decreased, MAT® treatment (by enabling the production of energy from glucose, a process requiring less oxygen ) may permit heart, skeletal muscle, skin, and other organs to function more normally, thus permitting them to repair damage and heal.
At times of reduced tissue oxygen, such as when circulation is decreased, MAT® treatment (by enabling increased production of energy from glucose, thus requiring less oxygen) may permit heart, skeletal muscle, skin, and other organs to function more normally and even to repair damage and heal. Research studies are planned to determine the effect of MAT® treatment on the rate of healing in situations of reduced tissue oxygen levels.
17. What scientific theory might explain MAT® treatment's ability to improve diabetic complications?
Because the insulin pulses are "seen" by the entire body, not just the liver, the pulses may alter and improve the metabolism of other organs besides the liver. In both normal and diabetic individuals, most organs rely on the metabolism of fatty acids for 70 percent to 80 percent of their fuel. However, the breakdown of fatty acids requires more oxygen at the cellular level than the breakdown of glucose for a given energy output. Pulsed insulin therapy may permit organs to use glucose as an energy source to a significantly greater extent than usual (due to increased pyruvate dehydrogenase activity) and thus decrease the organ's oxygen requirements.
18. What do published Scientific Research Studies show about MAT® treatment
MAT® treatment has been shown to be effective in halting the progression of diabetic kidney disease, reducing serious hypoglycemic attacks, and improving blood pressure control. For research published by ADRI and others on MAT® treatment and other topics, see References.
Copyright 2014 Aoki Diabetes Research Institute. ALL RIGHTS RESERVED
Conventional Insulin Therapy
Insulin injection site
Directly into a vein
Pattern of insulin delivery to the liver
Gradual rise and fall
Level of insulin available to the liver.