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

Original Article ↗ Hacker News Discussion ↗

Study & Treatment Overview

  • Paper describes ReCET, an endoscopic electroporation procedure that ablates duodenal mucosa, followed by GLP‑1 therapy (e.g., semaglutide).
  • Commenters note GLP‑1 drugs alone can already eliminate insulin in ~40% of type 2 diabetics; adding ReCET reportedly raises this to 86% in the n=14 study.
  • Some emphasize that the HN title omits “type 2” and “n=14,” calling the result promising but very early.

GLP‑1 / Tirzepatide Effects and Side Effects

  • Tirzepatide and related GLP‑1/GIP agonists are praised for large average weight loss (~20% of body weight in cited trial) and major reductions in risk of developing type 2 diabetes.
  • Several users on these drugs report mostly mild, transient GI side effects; others say side effects are exaggerated by social media and can be minimized by dose/schedule tweaks.
  • Debate over heart-rate changes and long‑term safety is present but unresolved; long‑duration (10–20 year) data are noted as lacking.
  • Some argue future dosing regimens and oral formulations will improve tolerability and adherence.

Type 1 vs Type 2 Diabetes

  • Multiple comments stress the article is about type 2 only.
  • Type 1 readers express both hope and frustration; stem‑cell–based beta‑cell replacement trials are discussed as “possibly within ~10 years,” with others warning this timeline has been repeatedly promised.
  • There is disagreement over how close a “cure” for type 1 really is, and the challenges of autoimmunity and immunosuppression.

Lifestyle, Diet, and Fasting vs Drugs

  • Strong thread arguing type 2 diabetes and obesity are often reversible or manageable with low‑carb/keto diets, fasting, and sustained weight loss; several personal remission stories.
  • Others counter that “just eat healthy” is not broadly effective, given environmental, cultural, and psychological drivers of overeating and addiction‑like behavior.
  • Ketosis, high‑fiber plant‑based diets, and fasting‑mimicking regimens are all promoted by different users; there is no consensus on a single “best” approach.

Obesity, Culture, and Personal Responsibility

  • Extended debate over whether obesity and type 2 are primarily:
    • personal responsibility/discipline problems, or
    • consequences of modern food systems, culture, and neurobiology.
  • Some argue GLP‑1s may address a more fundamental brain‑level “propensity to overeat,” while diet/exercise mainly treat symptoms.
  • Others reject this framing, insisting overeating is caused by bad diet and inactivity, not the other way around.

Trial Scale, Durability & Access

  • Several users highlight the tiny sample size (14 participants) and unclear duration of effect after stopping GLP‑1 drugs or reverting to prior lifestyle.
  • One commenter cites data that ~50% of people regain weight after stopping GLP‑1s, ~50% maintain or continue losing, suggesting behavior still matters.
  • Cost and access issues are raised: GLP‑1s can be $600–$1,000/month in the US, and continuous glucose monitors may not be covered for type 2 in some systems.