[HN Gopher] Diabetes Breakthrough: New Treatment Eliminates Insu...
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       Diabetes Breakthrough: New Treatment Eliminates Insulin for 86% of
       Patients
        
       Author : amichail
       Score  : 63 points
       Date   : 2024-10-17 20:46 UTC (2 hours ago)
        
 (HTM) web link (scitechdaily.com)
 (TXT) w3m dump (scitechdaily.com)
        
       | janice1999 wrote:
       | Paper: https://pubmed.ncbi.nlm.nih.gov/38692517/
       | 
       | > Recellularization via electroporation therapy (ReCET) is a
       | novel endoscopic procedure that uses electroporation to induce
       | cellular apoptosis and subsequent reepithelization.
        
         | arcticbull wrote:
         | ... plus GLP-1.
         | 
         | GLP-1s baseline eliminate insulin for about ~40% of people.
         | This boosts that number to 86%.
         | 
         | Note that Tirzepatide also reduces the chance of developing
         | type 2 in the first place by 94%, and I suspect that newer
         | generation receptor agonists will see higher insulin
         | discontinuation rates in general.
         | 
         | Very cool stuff all around. Might finally be able to put this
         | whole obesity-and-diabetes thing to bed.
        
           | metadat wrote:
           | Tirzepatide side effects sound pretty nasty, though less so
           | than dying in a diabetic coma.
           | 
           | https://en.wikipedia.org/wiki/Tirzepatide
        
             | arcticbull wrote:
             | Directionally each generation of these drugs targets more
             | receptors and has fewer side effects. Tirzepatide is also
             | amazing in that people lost an average of 20.9% of their
             | body weight in studies. [1]
             | 
             | [1] https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
        
               | metadat wrote:
               | What if I didn't want to lose weight? Would I be a bad
               | candidate?
        
             | tssva wrote:
             | The side effects are usually short lived. I'm on
             | tirzepatide and had some mild digestive issues for the 1st
             | 3 - 4 weeks and haven't had any since then. My side effects
             | when starting metformin were worse.
        
       | looperhacks wrote:
       | Note: This is about diabetes type 2, not type 1. Might be worth
       | to editorialize the heading in this case.
        
         | wwilim wrote:
         | eh, I had a brief glimmer of hope
        
           | tj-teej wrote:
           | As a T1D I empathize so strongly with this comment.
           | 
           | There was a promising example in China where Scientists cured
           | a single woman who had T1D. It's n=1, but the first step to a
           | cure is curing someone :)
           | 
           | Source: https://www.nature.com/articles/d41586-024-03129-3
        
             | 1123581321 wrote:
             | n=3 but the other two haven't been monitored for a year
             | yet. Promising.
        
             | mapt wrote:
             | Immunology & autoimmune attack is still a wild country
             | where discoveries are being made regularly and only a
             | handful of people have even a rough grasp of the terrain.
        
         | dyauspitr wrote:
         | Something that works for 95% of people with diabetes then.
         | Fantastic!
        
           | tzs wrote:
           | Don't only something like 25% of type 2 diabetics take
           | insulin?
        
             | coldcode wrote:
             | Most people with T2D do not take insulin, it's only useful
             | if your body cannot make a sufficient amount. In my case I
             | have no need for it, the cells became resistant to the
             | effects of insulin. 25% is probably a decent estimate.
        
       | jasonpeacock wrote:
       | How long does this cure last until the unhealthy diet & lifestyle
       | that originally caused the insulin resistance bring it back
       | again?
       | 
       | It's frustrating, as Type 2 diabetes is 100% manageable through
       | diet. You don't even have to exercise, just eat healthy. Today,
       | with the use of continuous glucose monitors, you have all the
       | data you need to make informed diet decisions - you know exactly
       | what "eat healthy" means for your body.
        
         | sctb wrote:
         | Not sarcasm: I'm sure it would be frustrating to see so much
         | scientific and commercial effort going into treating TIID
         | pharmacologically when you believe the solution is trivial. But
         | you could also consider all of these developments as evidence
         | that the prescription of "just eat healthy" isn't broadly
         | useful.
        
           | jasonpeacock wrote:
           | 100% agree, it's a modern cultural problem. We look for drug
           | and technology solutions because "doing the right thing" is
           | hard.
        
             | baq wrote:
             | GLP-1 drugs don't make you burn fat, they make you eat
             | healthy (or healthier, at least). That's why they're so
             | amazingly effective and the reason why is even more amazing
             | - they hack your reward subsystem.
        
             | mapt wrote:
             | When you say "it's a modern cultural problem", do you mean,
             | as most people appear to mean, "This is not a social
             | problem worth solving, these people deserve it for their
             | moral failings, and their death is a useful example for the
             | rest of us"?
             | 
             | Most people don't actually say it out loud, but this is all
             | directly implied by the "personal responsibility" retort
             | that is wildly popular among people who don't actually
             | suffer from a given malady, in response to attempts to
             | address it collectively.
        
           | meiraleal wrote:
           | > But you could also consider all of these developments as
           | evidence that the prescription of "just eat healthy" isn't
           | broadly useful.
           | 
           | As programmers, we usually prefer to remove code to remove
           | bug than adding patches on top of old code. Let's not pretend
           | that the same logic does not apply here.
           | 
           | That's clearly double unhealthy behavior and will bring
           | unintended consequences. Which might be better than the
           | current predicament but still let's not pretend this is not a
           | "monkeypatch".
        
         | nessguy wrote:
         | Considering the article mentions ReCET and semaglutide,
         | presumably most people in the study weren't resuming the
         | unhealthy diet.
         | 
         | Semaglutide is ozempic. By itself it can be enough to help
         | people get their A1C down through healthier diets.
         | 
         | For me to find the study especially interesting, I'd have to
         | see a comparison between ReCET + semaglutide vs just
         | semaglutide. And upon re-reading I see that's their plan.
         | 
         | > "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."
        
         | waldrews wrote:
         | s/Broken ankles are 100% manageable by not walking where you
         | could slip and fall. If only today's society made informed
         | decisions about their walking habits, we wouldn't need all
         | these artificial casts and surgeries. How long does a cured
         | ankle last till the lifestyle of walking around breaks it
         | again?/
        
         | stavros wrote:
         | Well, shit. I can't believe it never occurred to these obese
         | people to just eat right!
         | 
         | You, sir, are a modern messiah. Well done.
        
       | dyauspitr wrote:
       | I didn't seem to get this from the article but this this involve
       | taking semaglutide for the rest of your life or the diabetes
       | returns?
        
       | purpleblue wrote:
       | Big Pharma is going to get rid of this immediately.
        
         | jokoon wrote:
         | sir this is not reddit
        
       | mnw21cam wrote:
       | I wouldn't ignore the effect that having surgery and then two
       | weeks of a strictly controlled food intake has. That might
       | account for a large proportion of the success rate. I heard about
       | a study that found that the fasting required for bariatric
       | surgery actually provides a large proportion of the benefit of
       | the procedure.
       | 
       | If you catch type 2 diabetes before it gets so bad that it has
       | killed off the beta cells, then your best treatment is to fast
       | for a while. After a couple of days, you should notice a massive
       | improvement in glucose control. A week of fasting a couple of
       | times a year might be all it takes to give you a complete cure.
       | YMMV, but in my opinion (and that of a whole load of people who
       | know what they're talking about) it's better than filling
       | yourself with drugs.
       | 
       | After the beta cells have been killed off by overwork, yeah, you
       | need insulin. But you can still reduce the amount you need by
       | losing weight.
        
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       (page generated 2024-10-17 23:00 UTC)