8 ms·

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

286 points by amichail 2y ago

janice1999 2y ago
Paper: https://pubmed.ncbi.nlm.nih.gov/38692517/ 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 2y ago
  ... 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 2y ago
    Tirzepatide side effects sound pretty nasty, though less so than dying in a diabetic coma. https://en.wikipedia.org/wiki/Tirzepatide https://en.wikipedia.org/wiki/Tirzepatide
    - arcticbull 2y ago
      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 https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
      - metadat 2y ago
        What if I didn't want to lose weight? Would I be a bad candidate?
        rootusrootus 2y ago
        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.
        phil21 2y ago
        > 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.
        arcticbull 2y ago
        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/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5702468/ [2] https://pmc.ncbi.nlm.nih.gov/articles/PMC5946208/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5946208/ [3] https://pmc.ncbi.nlm.nih.gov/articles/PMC3780395/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3780395/
    - tssva 2y ago
      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.
    - phil21 2y ago
      The side effects are wildly exaggerated due to the current social media discourse on the subject. I am in a pretty close knit community of 100s of people on the subject and while the side effects should not be discounted, figuring out ways to properly take the medication more or less eliminates them completely for nearly everyone. The current dosing and schedules of the drug (and all GLP-1s for that matter) are largely an effect of what was tested during trials and not what will end up being most effective a decade from now. The rest of it is patient compliance and liability from drug manufacturers. The most obvious two things to point at are that the half life of Tirzepatide is 5 days while the prescriptions are for 7 day intervals for ease of use. The other would be the rather large jumps in dosing (2.5mg per step) available in injector pen forms and prescribed. Some bleeding edge doctors are willing to take the risk to go outside dosing and schedule guidelines, but not many. Even then, the side effects seem to be rather minor compared to obesity or T2D and few and are far between. I also had similarly reactions to the topic before I started to really look into it and dig deeper. I firmly believe these medications will change society at a level only antibiotics have so far.
      - s1artibartfast 2y ago
        I worked in pharmaceutical development and absolutely agree on the labeled dosing point. When each arm of your study costs X00 million dollars and Y years, you dont optimize dosing intervals. Moreover, there is no global optimum due to biologic variability in patients. Some patients are flat out non-responders, and some tolerate dosing intervals 10X the average. That said, there is nothing magic about aligning the half-life and interval. 50% isn't a minimum concentration threshold for efficacy. depending on the product, it can be anything. Sometimes area under the curve is the relevant parameter. Sometimes you want the product to go under a limit before redosing. The one part I disagree with is about bleeding edge doctors. Maybe it is my field, but I find doctors to be readily willing to completely ignore the labeling. Statutory protections are high for clinicians operating off label. If someone is interested, I suggest they raise it with their doctor. For most medications, the dosing is far from the individual optimum.
        Spooky23 2y ago
    - consteval 2y ago
      Dying in a diabetic coma is just one thing. Diabetes and other metabolic disorders are all very closely related. We're talking dozens of severe, deadly, and lifespan reducing illnesses. Odds are if you're diabetic long term you're also obese, and have atherosclerosis, and high blood pressure, and high cholesterol, etc.
looperhacks 2y ago
Note: This is about diabetes type 2, not type 1. Might be worth to editorialize the heading in this case.
- wwilim 2y ago
  eh, I had a brief glimmer of hope
  - tj-teej 2y ago
    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 https://www.nature.com/articles/d41586-024-03129-3
    - 1123581321 2y ago
      n=3 but the other two haven’t been monitored for a year yet. Promising.
    - mapt 2y ago
      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.
    - caseyy 2y ago
      There is a study running for this in the UK currently [0], and I expect there are worldwide studies running now. This is the time for those interested and eligible to register. But for the rest of us, the treatment seems to be inevitable now. The question is how long until it's proven safe, the red tape is cut through, and it enters the market. I would speculate, unless something catastrophic happens, it should be available within 10 years. No doubt, the current T1D market players will have created some legal moat, so it might be best for the patients if these companies are the ones to bring the treatment to the market. But we shall see - the current big pharma in diabetes space is heavily invested in drug production rather than implantation procedures. It is a very different business model requiring very different facilities, management, and technology. [0] https://www.diabetes.org.uk/our-research/get-involved/take-part-in-research/type-1-stem-cell https://www.diabetes.org.uk/our-research/get-involved/take-p...
jasonpeacock 2y ago
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 2y ago
  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 2y ago
    100% agree, it's a modern cultural problem. We look for drug and technology solutions because "doing the right thing" is hard.
    - baq 2y ago
      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.
      - nradov 2y ago
        GLP-1 drugs seem to increase resting heart rate. I suspect that also increases total daily energy expenditure, although I don't know that we have reliable data on that yet.
        rootusrootus 2y ago
        That can happen, but is not universal. My resting heart rate has been dropping (probably in lock step with my weight), it has not risen one bit since I started taking tirzepatide. And my heart rate variability has been trending up, not down. Why do you suspect it changes energy expenditure?
dyauspitr 2y ago
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 2y ago
[flagged]
- jokoon 2y ago
  sir this is not reddit
mnw21cam 2y ago
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.
- deleted 2y ago
  [deleted]
- nradov 2y ago
  For type-2 diabetes, various forms of dietary therapy such as nutritional ketosis have proven extremely effective in reducing or even eliminating many patients' need for exogenous insulin. But we usually refer to that as putting the condition into remission rather than a "cure". https://doi.org/10.1530/EDM-22-0295 https://doi.org/10.1530/EDM-22-0295
  - hal-eisen 2y ago
    This. I was diagnosed with type 2 diabetes about two and a half years ago. After doing some research, I put myself on a strict keto diet. Within about a month, my A1C went from over 13 to hovering around 6 and has stayed there. Never took any diabetes medication. I do give myself a "vacation" from the diet about once a month, which I usually reserve for a special occasion.
    - anitil 2y ago
      Do you find that this requires an unusual amount of self-control? I have no reason to manage my food intake, but in the limited times where I have I've found it quite difficult
TexanFeller 2y ago
I’m unsurprised that a large component of the treatment is effectively just “lose weight”. For many years I’ve heard accounts of significant weight loss reversing type 2 diabetes.
- rootusrootus 2y ago
  Anecdotally, I've observed with my own body that there is a very direct correlation between weight and all of the health metrics. And it does not take as much weight change as you might think in order to see the metrics move. Another thing is consumption. All of my metrics start moving immediately in the positive direction when I'm on a calorie restricted diet, even before I start seeing results on the scale. I could be unique but I doubt it. The problem, of course, is that just like CICO, observing the relationship between weight and health is educational but useless as a strategy. If it were that easy there would be no overweight people in the world.
- crossroadsguy 2y ago
  Even my allergies are tamed when I am at the right weight and physically very and consistently active. (It might just be coincidence though). Cutting off refined/white sugar almost completely has helped a lot I guess (I do have a sweets cheat day every 3-5 months. It’s not planned but somehow this is how it has worked with visits to friends and relatives). Is type 2 a permanent disease? Or is like when you lifestyle is bad and your sugar remains high/etc you are suffering from type 2 diabetes, but when your lifestyle and weight and great and sugar is well under control you don’t have type 2 diabetes, but if that changes you can get it again? Or it’s like - once “marked with type 2” no matter the sugar marker results you are a type 2 patient forever?
  - beef234 2y ago
    It depends how many beta cells you have left. Usually by the time you are diagnosed you've lost at least 50%. Once they are gone you'll need exogenous insulin.
    - malfist 2y ago
wwarner 2y ago
14 participants
beef234 2y ago
It's a cure as long as you have $600-$1000 per month in the US for ozempic or tirzepatide.
- malfist 2y ago
  A recent study found that $5 per dose would provide enough profit to pay for R&D and then some
- snvzz 2y ago
  >ozempic Hint: You can substitute for that with sheer willpower.
amluto 2y ago
Here’s a paper that describes the theory and a study of a different procedure attempting to do the same thing: https://diabetesjournals.org/care/article/39/12/2254/31913/Endoscopic-Duodenal-Mucosal-Resurfacing-for-the https://diabetesjournals.org/care/article/39/12/2254/31913/E...
LeonB 2y ago
I wish the heading (at HN) included “n=14”.
backtoyoujim 2y ago
The pessimist in me thinks pharma is doing this as a response to the inbound possibility of cheap insulin being available in the USA.

286 points by amichail 2y ago

janice1999 2y ago

Paper: https://pubmed.ncbi.nlm.nih.gov/38692517/ 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 2y ago
... 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 2y ago
  Tirzepatide side effects sound pretty nasty, though less so than dying in a diabetic coma. https://en.wikipedia.org/wiki/Tirzepatide https://en.wikipedia.org/wiki/Tirzepatide
  - arcticbull 2y ago
    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 https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
    - metadat 2y ago
      What if I didn't want to lose weight? Would I be a bad candidate?
      - rootusrootus 2y ago
        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.
        phil21 2y ago
        > 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.
        arcticbull 2y ago
        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/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5702468/ [2] https://pmc.ncbi.nlm.nih.gov/articles/PMC5946208/ https://pmc.ncbi.nlm.nih.gov/articles/PMC5946208/ [3] https://pmc.ncbi.nlm.nih.gov/articles/PMC3780395/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3780395/
  - tssva 2y ago
    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.
  - phil21 2y ago
    The side effects are wildly exaggerated due to the current social media discourse on the subject. I am in a pretty close knit community of 100s of people on the subject and while the side effects should not be discounted, figuring out ways to properly take the medication more or less eliminates them completely for nearly everyone. The current dosing and schedules of the drug (and all GLP-1s for that matter) are largely an effect of what was tested during trials and not what will end up being most effective a decade from now. The rest of it is patient compliance and liability from drug manufacturers. The most obvious two things to point at are that the half life of Tirzepatide is 5 days while the prescriptions are for 7 day intervals for ease of use. The other would be the rather large jumps in dosing (2.5mg per step) available in injector pen forms and prescribed. Some bleeding edge doctors are willing to take the risk to go outside dosing and schedule guidelines, but not many. Even then, the side effects seem to be rather minor compared to obesity or T2D and few and are far between. I also had similarly reactions to the topic before I started to really look into it and dig deeper. I firmly believe these medications will change society at a level only antibiotics have so far.
    - s1artibartfast 2y ago
      I worked in pharmaceutical development and absolutely agree on the labeled dosing point. When each arm of your study costs X00 million dollars and Y years, you dont optimize dosing intervals. Moreover, there is no global optimum due to biologic variability in patients. Some patients are flat out non-responders, and some tolerate dosing intervals 10X the average. That said, there is nothing magic about aligning the half-life and interval. 50% isn't a minimum concentration threshold for efficacy. depending on the product, it can be anything. Sometimes area under the curve is the relevant parameter. Sometimes you want the product to go under a limit before redosing. The one part I disagree with is about bleeding edge doctors. Maybe it is my field, but I find doctors to be readily willing to completely ignore the labeling. Statutory protections are high for clinicians operating off label. If someone is interested, I suggest they raise it with their doctor. For most medications, the dosing is far from the individual optimum.
      - Spooky23 2y ago
  - consteval 2y ago
    Dying in a diabetic coma is just one thing. Diabetes and other metabolic disorders are all very closely related. We're talking dozens of severe, deadly, and lifespan reducing illnesses. Odds are if you're diabetic long term you're also obese, and have atherosclerosis, and high blood pressure, and high cholesterol, etc.

looperhacks 2y ago

Note: This is about diabetes type 2, not type 1. Might be worth to editorialize the heading in this case.

wwilim 2y ago
eh, I had a brief glimmer of hope
- tj-teej 2y ago
  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 https://www.nature.com/articles/d41586-024-03129-3
  - 1123581321 2y ago
    n=3 but the other two haven’t been monitored for a year yet. Promising.
  - mapt 2y ago
    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.
  - caseyy 2y ago
    There is a study running for this in the UK currently [0], and I expect there are worldwide studies running now. This is the time for those interested and eligible to register. But for the rest of us, the treatment seems to be inevitable now. The question is how long until it's proven safe, the red tape is cut through, and it enters the market. I would speculate, unless something catastrophic happens, it should be available within 10 years. No doubt, the current T1D market players will have created some legal moat, so it might be best for the patients if these companies are the ones to bring the treatment to the market. But we shall see - the current big pharma in diabetes space is heavily invested in drug production rather than implantation procedures. It is a very different business model requiring very different facilities, management, and technology. [0] https://www.diabetes.org.uk/our-research/get-involved/take-part-in-research/type-1-stem-cell https://www.diabetes.org.uk/our-research/get-involved/take-p...

jasonpeacock 2y ago

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 2y ago
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 2y ago
  100% agree, it's a modern cultural problem. We look for drug and technology solutions because "doing the right thing" is hard.
  - baq 2y ago
    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.
    - nradov 2y ago
      GLP-1 drugs seem to increase resting heart rate. I suspect that also increases total daily energy expenditure, although I don't know that we have reliable data on that yet.
      - rootusrootus 2y ago
        That can happen, but is not universal. My resting heart rate has been dropping (probably in lock step with my weight), it has not risen one bit since I started taking tirzepatide. And my heart rate variability has been trending up, not down. Why do you suspect it changes energy expenditure?

dyauspitr 2y ago

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 2y ago

[flagged]

jokoon 2y ago
sir this is not reddit

mnw21cam 2y ago

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.

deleted 2y ago
[deleted]
nradov 2y ago
For type-2 diabetes, various forms of dietary therapy such as nutritional ketosis have proven extremely effective in reducing or even eliminating many patients' need for exogenous insulin. But we usually refer to that as putting the condition into remission rather than a "cure". https://doi.org/10.1530/EDM-22-0295 https://doi.org/10.1530/EDM-22-0295
- hal-eisen 2y ago
  This. I was diagnosed with type 2 diabetes about two and a half years ago. After doing some research, I put myself on a strict keto diet. Within about a month, my A1C went from over 13 to hovering around 6 and has stayed there. Never took any diabetes medication. I do give myself a "vacation" from the diet about once a month, which I usually reserve for a special occasion.
  - anitil 2y ago
    Do you find that this requires an unusual amount of self-control? I have no reason to manage my food intake, but in the limited times where I have I've found it quite difficult

TexanFeller 2y ago

I’m unsurprised that a large component of the treatment is effectively just “lose weight”. For many years I’ve heard accounts of significant weight loss reversing type 2 diabetes.

rootusrootus 2y ago
Anecdotally, I've observed with my own body that there is a very direct correlation between weight and all of the health metrics. And it does not take as much weight change as you might think in order to see the metrics move. Another thing is consumption. All of my metrics start moving immediately in the positive direction when I'm on a calorie restricted diet, even before I start seeing results on the scale. I could be unique but I doubt it. The problem, of course, is that just like CICO, observing the relationship between weight and health is educational but useless as a strategy. If it were that easy there would be no overweight people in the world.
crossroadsguy 2y ago
Even my allergies are tamed when I am at the right weight and physically very and consistently active. (It might just be coincidence though). Cutting off refined/white sugar almost completely has helped a lot I guess (I do have a sweets cheat day every 3-5 months. It’s not planned but somehow this is how it has worked with visits to friends and relatives). Is type 2 a permanent disease? Or is like when you lifestyle is bad and your sugar remains high/etc you are suffering from type 2 diabetes, but when your lifestyle and weight and great and sugar is well under control you don’t have type 2 diabetes, but if that changes you can get it again? Or it’s like - once “marked with type 2” no matter the sugar marker results you are a type 2 patient forever?
- beef234 2y ago
  It depends how many beta cells you have left. Usually by the time you are diagnosed you've lost at least 50%. Once they are gone you'll need exogenous insulin.
  - malfist 2y ago

wwarner 2y ago

14 participants

beef234 2y ago

It's a cure as long as you have $600-$1000 per month in the US for ozempic or tirzepatide.

malfist 2y ago
A recent study found that $5 per dose would provide enough profit to pay for R&D and then some
snvzz 2y ago
>ozempic Hint: You can substitute for that with sheer willpower.

amluto 2y ago

Here’s a paper that describes the theory and a study of a different procedure attempting to do the same thing: https://diabetesjournals.org/care/article/39/12/2254/31913/Endoscopic-Duodenal-Mucosal-Resurfacing-for-the https://diabetesjournals.org/care/article/39/12/2254/31913/E...

LeonB 2y ago

I wish the heading (at HN) included “n=14”.

backtoyoujim 2y ago

The pessimist in me thinks pharma is doing this as a response to the inbound possibility of cheap insulin being available in the USA.