Promising new treatment strategy for type 2 diabetes

Groundbreaking research presented at UEG Week 2024 reveals a promising new treatment strategy for type 2 diabetes (T2D) that could significantly reduce or even eliminate the need for insulin therapy.

This innovative approach, which combines a novel procedure known as ReCET (Re-Cellularization via Electroporation Therapy) with semaglutide, resulted in the elimination of insulin therapy for 86% of patients.

Globally, T2D affects 422 million people, with obesity recognized as a significant risk factor. While insulin therapy is commonly used to manage blood sugar levels in T2D patients, it can result in side effects such as weight gain and further complicate diabetes management. A need therefore exists for alternative treatment strategies.

The first-in-human study included 14 participants aged 28 to 75 years, with body mass indices ranging from 24 to 40 kg/m². Each participant underwent the ReCET procedure under deep sedation, a treatment intended to improve the body's sensitivity to its own insulin. Following the procedure, participants adhered to a two-week isocaloric liquid diet, after which semaglutide was gradually titrated up to 1mg/week. 

Remarkably, at the 6- and 12-month follow-up, 86% of participants (12 out of 14) no longer required insulin therapy, and this success continued through the 24-month follow-up. In these cases, all patients maintained glycaemic control, with HbA1c levels remaining below 7.5%.

The maximum dose of semaglutide was well-tolerated by 93% of participants, one individual could not increase to the maximum dose due to nausea. All patients successfully completed the ReCET procedure, and no serious adverse effects were reported.

These findings are very encouraging, suggesting that ReCET is a safe and feasible procedure that, when combined with semaglutide, can effectively eliminate the need for insulin therapy."

Dr. Celine Busch, Study Lead Author and Research Associate, Gastroenterology and Hepatology, Amsterdam UMC

Busch further added, "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."

Looking ahead, the researchers plan to conduct larger randomized controlled trials to further validate these findings. Dr Busch added, "We are currently conducting the EMINENT-2 trial with the same inclusion and exclusion criteria and administration of semaglutide, but with either a sham procedure or ReCET. This study will also include mechanistic assessments to evaluate the underlying mechanism of ReCET."