16th March 2017 – New evidence has emerged to support the idea that type 2 diabetes might be reversible.
Canadian researchers say they have demonstrated that it is possible to put patients into remission in as little as 4 months. However, they say it involves intensive medical treatment and lifestyle changes.
Type 2 diabetes is usually considered a long-term condition that gets worse over time. As the disease progresses, patients may need increasingly complex combinations of drugs as well as sticking to a healthy diet and making sure they get enough exercise.
There are 3.5 million people in the UK diagnosed with diabetes, and most of these have type 2 diabetes. The condition occurs when a person's pancreas fails to produce enough of the hormone, insulin, or the body doesn't react properly to insulin.
Insulin is needed to manage glucose, or sugar, levels in the blood and to convert glucose into energy.
The latest study, in The Journal of Clinical Endocrinology and Metabolism, involved 83 people aged between 30 and 80 who had been diagnosed with type 2 diabetes during the previous 3 years.
The researchers, from McMaster University, Hamilton, Ontario, divided the participants into 3 study groups.
Two of the groups received an intensive metabolic intervention in which they were asked to adhere to a personalised exercise programme and a suggested meal plan that reduced their daily calorie intake by 500 to 750 calories a day. The only difference between these groups was that one involved treatment for 16 weeks and the other lasted only 8 weeks.
The third group received just standard diabetes care, which consisted of advice from their usual healthcare provider about keeping their blood sugar under control and following a healthy lifestyle.
All the volunteers were checked by a nurse and a dietitian at regular intervals and received oral medications and insulin at bedtime to keep their blood glucose levels under tight control. All the participants' underwent an HbA1C blood test which gives an indication of how well diabetes is being controlled at 8,16, 20, 28 and 52 weeks after the trial began. They also undertook oral glucose tolerance tests.
After the intervention, individuals in both groups stopped taking diabetes medications and were encouraged to continue with lifestyle changes.
Three months after treatment ended, the researchers found that 11 out of the 27 people in the 16-week intervention group met HbA1C criteria for complete or partial diabetes remission, compared to only 4 out of 28 individuals who received standard diabetes care.
Three months after finishing the 8-week intervention, 6 out of 28 people in that group met the same criteria for complete or partial diabetes remission.
'Evidence is mounting'
Commenting on the research by email, Emily Burns, research communications manager at Diabetes UK, says: "We know that diet, exercise and medications can help people with type 2 diabetes to manage their condition. We’re starting to see mounting evidence that putting type 2 diabetes into remission is feasible as well.
"This is really interesting research, but we need longer trials in larger numbers of people to see if their approach works for the long-term."
A trial taking place in Scotland and Tyneside is currently investigating whether an intensive programme of weight loss and weight management can reverse type 2 diabetes in the long-term for people diagnosed with the condition.
Diabetes UK, which is funding the study, says results from the Diabetes Remission Clinical Trial (DiRECT) are expected to emerge in 2018.
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