PIONEERING research presented at the United European Gastroenterology (UEG) Week 2024 has revealed a new treatment approach for Type 2 diabetes (T2D) that could dramatically reduce, or even eliminate, the need for insulin therapy.
Over 422 million people globally live with T2D, with most patients relying on insulin therapy to manage their blood sugar levels. However, insulin therapy often leads to side effects like weight gain, making diabetes management more challenging. The new treatment aims to offer a viable alternative.
The first-in-human study involved 14 participants aged 28–75 years, with BMIs ranging from 24–40 kg/m². Each patient underwent a novel procedure called Re-Cellularization via Electroporation Therapy (ReCET), an endoscopic treatment that uses electroporation to ablate the duodenal mucosa and improve the body’s sensitivity to endogenous insulin. After the procedure, patients followed a 2-week liquid diet before being started on semaglutide, which was gradually increased to a weekly dose of 1 mg.
At the 6- and 12-month follow-ups, 12 out of 14 participants (86%) had stopped using insulin and maintained good blood sugar control. At the 24-month mark, their HbA1c levels remained below 7.5%. The treatment was well-tolerated, with 93% of participants reaching the maximum dose of semaglutide, although one experienced nausea.
“Unlike drug therapy, which requires daily medication adherence, ReCET is compliance-free, addressing the critical issue of ongoing patient adherence in the management of T2D. In addition, the treatment is disease-modifying: it improves the patient’s sensitivity to their own (endogenous) insulin, tackling the root cause of the disease, as opposed to currently available drug therapies, that are at best disease-controlling,” stated lead author Celine Busch, Amsterdam UMC, the Netherlands.
Encouraged by these results, the researchers are planning to launch larger randomised controlled trials to further validate the findings. The EMINENT-2 trial is now ongoing, with the addition of a sham procedure and mechanistic assessments to better understand how ReCET works.
Ada Enesco, EMJ
Reference
Busch CBE et al. Durable effects of duodenal ablation using electroporation combined with semaglutide to eliminate insulin therapy in patients with type-2 diabetes; the 24-month results. UEG Week 2024, 12–15 October, 2024.
