Introduction: Re-Cellularization via Electroporation Therapy (ReCET™), a novel endoscopic procedure using electroporation to elicit apoptosis of the duodenal mucosa. In this study we aimed to eliminate insulin in T2D patients using a single ReCET procedure combined with GLP-1RA. Safety, feasibility, and efficacy of ReCET using the Endogenex system were assessed. Methods: First in human study with 14 T2D patients on basal insulin (BMI 24-40 kg/m2; HbA1c ≤ 8.0%; C-peptide ≥ 0.2 nmol/l). All underwent ReCET after which semaglutide was titrated up to 1mg. Primary endpoints were: feasibility (technical success rate, procedure time catheter in - out, % GLP-1RA tolerance); safety ((S)AE, hypoglycemic events); efficacy (off insulin at 6 mo; HbA1c ≤ 7.5%). Results: ReCET showed 100% technical success rate. Procedure time was 58 (IQR 49-79) min. Maximum semaglutide dosage was tolerated by 13 patients. No device related SAEs were observed. One non-severe hypoglycemic event occurred. At 6 mo, 12 patients were off insulin. A significant improvement in several glycemic and metabolic parameters was observed (Table 1); HbA1c decreased (7.2 to 6.6% p=0.003) and TIR increased (72 to 91% p=0.022). Conclusion: ReCET is safe and feasible. ReCET combined with semaglutide may effectively eliminate insulin in selected T2D patients, while improving glycemic control and metabolic health. Disclosure C.B.E.Busch: None. S.Meiring: None. A.C.G.Van baar: None. F.Holleman: None. M.Nieuwdorp: Advisory Panel; caelus health. J.J.Bergman: Consultant; Endogenex, Fractyl Health, Inc., Digma Medical, Research Support; Endogenex, Fractyl Health, Inc., Digma Medical.