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Type 2 diabetes: New treatment eliminates insulin for 86% of patients

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196 points amichail | 6 comments | 17 Oct 24 20:46 UTC | HN request time: 0s | source | bottom
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janice1999 ◴[17 Oct 24 21:24 UTC] No.41873971[source]▶
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.

replies(1): >>41873977 #
arcticbull ◴[17 Oct 24 21:26 UTC] No.41873977[source]▶
... 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.

replies(1): >>41874242 #
metadat ◴[17 Oct 24 21:58 UTC] No.41874242[source]▶
Tirzepatide side effects sound pretty nasty, though less so than dying in a diabetic coma.

https://en.wikipedia.org/wiki/Tirzepatide

replies(3): >>41874264 #>>41874320 #>>41874776 #
1. arcticbull ◴[17 Oct 24 22:01 UTC] No.41874264[source]▶
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

replies(1): >>41874304 #
2. metadat ◴[17 Oct 24 22:08 UTC] No.41874304[source]▶
What if I didn't want to lose weight? Would I be a bad candidate?
replies(2): >>41874726 #>>41875333 #
3. rootusrootus ◴[17 Oct 24 23:08 UTC] No.41874726[source]▶
Tirzepatide does not force you to lose weight, it makes it much easier to stick to your diet. Maybe too easy, since people who are not prepared to manage their diet may find themselves missing meals accidentally (lots of stories of people losing more than 2 pounds a week, which is very satisfying when it happens but not the healthiest way to drop weight).

Make sure you are getting sufficient calories and you won't lose any weight.

The caveat is that it slows digestion down and this effectively reduces your capacity to eat a lot of food. So maintaining a high calorie diet may require some changes to increase the energy density of your food.

replies(1): >>41874793 #
4. phil21 ◴[17 Oct 24 23:17 UTC] No.41874793{3}[source]▶
> lots of stories of people losing more than 2 pounds a week, which is very satisfying when it happens but not the healthiest way to drop weight

Folks should follow medical advice and do what works for them, but be aware that these guidelines were established prior to the obesity epidemic. I’d be highly surprised if someone weighing 300lbs vs. the same person weighing 190lbs should be losing weight at the same rate per week.

I imagine these will be updated to be body weight (or fat) adjusted as time goes on, like some doctors are already doing.

replies(1): >>41876433 #
5. Spooky23 ◴[18 Oct 24 00:47 UTC] No.41875333[source]▶
It doesn’t make you lose weight per se.

It is best described by me turning the volume down on your desire for a dopamine hit. You’ll eat what you need, vs going for the helping of comfort food. Many people see a more active libido, less alcohol desire and other factors.

We’ll see lots of other indications I’m sure. This drug is like the Keytruda of self control.

6. arcticbull ◴[18 Oct 24 04:47 UTC] No.41876433{4}[source]▶
Also, I haven't really found anything that says losing fat faster than 2 pounds per week (and realistically it's not possible to lose more than like ~2500kcal/day * 7 = 5 lbs per week even when 100% fasted) is actually unhealthy. Studies show it does not make it any more or less likely that you'll regain weight if you do it fast vs slow. Folks say this but I'm not sure why...

This study says you may get a better body composition if you do it slowly, but also resistance training during weight loss helps prevent 93% of muscle mass loss. [1, 2]

This study says fast loss means more loss, and is actually better for long-term maintenance. [3]

Due to the risk profile of obesity, and this is not medical advice, I think there's a lot of room to take more risk if it helps get you back to a normal weight. The consequences of not are just too high.

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC5702468/

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC5946208/

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC3780395/