remission

Research finds that controlled weight management puts type 2 diabetes into remission

by Barbara Hewitt on March 13, 2019

Weight management programmes delivered by medical doctors do help people with type 2 diabetes to such an extent that many end up in remission, new research has confirmed.

More than a third, some 36%, of people with type 2 diabetes who took part in the Diabetes Remission Clinical Trial (Direct) in the UK are still in remission after two years.

Weight Loss

(By Rostislav_Sedlacek/Shutterstock.com)

The new results build on the first year findings, announced in December 2017, which showed that 46% of participants were in remission after 12 months. A year later, 70% of those participants are still in remission.

Experts told a conference that remission is closely linked to weight loss with 64% of participants who lost more than 10 kilos were in remission at two years. Participants regained some weight, as expected, between the first and second years of the trial.

However, those who were in remission after one year, and who had stayed in remission, had lost a greater amount of weight on average 15.5 kilos than those who didn’t stay in remission who lost 12 kilos.

As well as resulting in remission for some people, there appear to be additional benefits to taking part in a weight management programme overall. These include a reported better quality of life, improved blood glucose levels and a reduced need for diabetes medications.

Understanding why significant weight loss results in remission of type 2 diabetes is at the heart of DiRECT. Studies have so far revealed that weight loss reduces the levels of fat inside the liver and pancreas, which in turn leads to the pancreas ‘rebooting’ insulin production again.

By understanding the biology of remission, professor Roy Taylor, director of Newcastle University’s Magnetic Resonance Centre and co-primary investigator of the DiRECT trial, and professor Mike Lean, head of human nutrition at Glasgow University and a diabetes specialist at Glasgow Royal Infirmary, believe it should be possible to provide better care for people diagnosed with type 2 diabetes in the future.

‘These results are a significant development, and we now understand the biological nature of this reversible condition. However, everyone in remission needs to know that evidence to date tells us that your type 2 diabetes will return if you regain weight,’ said Taylor.

Lean said that the results are exciting. ‘Proving in DiRECT that type 2 diabetes can be put into remission for two years in over two thirds of people, if they can lose over 10 kilos, is incredible,’ he pointed out.

‘People with type 2 diabetes, and healthcare professionals, have told us their top research priority is can the condition be reversed or cured. We can now say, with respect to reversal, that yes it can. Now we must focus on helping people maintain their weight loss and stay in remission for life,’ he added.

Dr Elizabeth Robertson, director of research at charity Diabetes UK, explained that remission can be life changing. ‘DiRECT offers one potential solution, we are committed to working with the researchers and the NHS to ensure these exciting findings reach people with type 2 diabetes as soon as possible,’ she said.

‘But we know type 2 diabetes is a complex condition, and this approach will not work for everyone. That’s why we’re continuing to invest in further research, to understand the biology underlying remission and find ways to make remission a reality for as many people as possible,’ she added.

One woman who took part in the trial and has been in remission for two years said it has been amazing. ‘I was so pleased when I was told I was in remission. I thought it’s all been worth it; going to the hospital, taking blood and doing all the tests. When they showed me the scan of the liver and the difference in fat, I was elated,’ she said.

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