DDW NewsNovel Endoscopic Treatment Improves Glycemic Control and Eliminates Need for Insulin in Patients with Type 2 Diabetes

Let’s delve into the groundbreaking application of endoscopic electroporation and semaglutide that’s changing the game in diabetes management.

First off, the EMINENT study is unveiling a revolutionary approach in treating type 2 diabetes. This method combines endoscopic electroporation, known as ReCET, with the medication semaglutide. The main goal is to reduce or potentially eliminate the need for insulin, revolutionizing glycemic control.

The innovative ReCET procedure employs electroporation to ablate the superficial layer of mucosa in the small intestine. Researchers hope that by rejuvenating the duodenal lining and employing a GLP-1 receptor agonist, they could address insulin resistance, the fundamental problem in type 2 diabetes.

Interestingly, ReCET doesn’t use extreme temperatures to ablate intestinal tissue. Rather, it uses a pulsed electric field, yielding precise control and limited depth of penetration. This method disrupts the cellular membrane of the mucosa and superficial submucosa, triggering natural cell death within a day, thereby significantly minimizing the risk of complications.

A single-arm pilot study conducted as part of EMINENT involved 14 patients with type 2 diabetes using long-acting basal insulin. All patients underwent the ReCET procedure and started on semaglutide two weeks later. Researchers noted the feasibility and safety of ReCET, with a 100% success rate and no serious adverse events.

Key results were impressive. After a year, 86% of patients maintained glycemic control without insulin, fasting plasma glucose levels improved significantly, HbA1c levels dropped, and liver fat percentage reduced by over 50%.

However, it’s important to recognize that attributing these outcomes to ReCET or semaglutide independently is challenging due to the single-arm nature of the study. Still, there’s a compelling case for their combined effect. With only 20% of insulin-dependent patients typically able to stop insulin after receiving a GLP-1 receptor agonist, the 86% success rate observed is hard to attribute to semaglutide alone.