While several essays have shown that a substantial loss of weight through diet and lifestyle can reverse type 2 diabetes, a new research published in 'Diabetology' is among the first to demonstrate the subsequent impact of remission of the resultsCardiovascular.The study was conducted by Professor Edward Gregg, director of the population of health of the University of Medicine and Health Sciences RCSI, Dublin, Ireland, and his colleagues.
Thus, the work demonstrates that in the patients who participated in the AHEAD LOOK study, those with some evidence of remission had a rate of 40% lower cardiovascular disease (CDV) and a 33% lower rate of chronic renal disease (ERC) (ERC).
It should be noted that the AHEAD Look Study compared the effect of intensive lifestyle intervention for 12 years with the support and education about diabetes on cardiovascular diseases and other long -term health conditions.The study, conducted between 2001 and 2016, recruited and randomized 5,145 adults overweight or obesity between 45 and 76 years with type 2 diabetes.
The authors carried out an 'post hoc' observational analysis of the participants in both groups, classified them according to the state of remission and then compared the long -term results (described below) according to any remission and the duration of the referral, for a period12 years.They compared the incidence of ECV and ERC among more than 4,000 participants, respectively, according to the achievement and duration of diabetes.
58% of the participants were women and had an average age of 59 years, an average duration of 6 -year diabetes and an average BMI of 35.8 kg/m 2 (in the range of serious obesity).The authors applied an epidemiological definition of remission: do not take medications for diabetes and have a glucosylated hemoglobin (HBA 1C, a measure of blood sugar control) less than 48 mmol/mol (6.5%) at a single moment.
The team defined the high -risk ERC or very high risk according to the criteria for the improvement of the global results of the renal disease (Kdigo), and the incidence of ECV as any appearance of acute non -fatal heart attack, stroke, admission by anginaor death by ECV.
Participants with evidence of some diabetes remission during follow -up had a 33% lower ERC rate and a 40% lower ECV rate in the analysis that adjusted HBA 1C, blood pressure, fat in the blood, the backgroundof ECV, the duration of diabetes and the intervention group, compared to participants without remission.The magnitude of risk reduction was higher for participants with longer term remission evidence.
The authors claim that they observed three main findings related to the implications of achieving the remission of diabetes.First, although 18% of the participants reached the remission at some time during the follow -up, the percentage of participants with current remission had decreased to 3% in the eighth year of the study, which underlines the challenges of maintaining the weight throughlifestyle interventions.
Secondly, despite the relatively short duration of most remission episodes, they found that any achievement of the remission was associated with 33% and 40% lower rates in ERC and ECV, respectively, compared to the participantsthat did not achieve the remission, and the risk the reduction was even greater (55 % and 49 %, respectively) among those who had evidence of at least 4 years of remission (consult Table 2 and Figure 2 of the full article).
Third, participants with short -term diabetes, HBA 1c low and weight lossOf great magnitude it was more likely to experience a remission.The authors conclude that the associations that found "can be explained by improvements after the beginning in weight, physical condition, HBA 1C and LDL (bad) cholesterol."
Finally, the authors conclude that being the first intervention study that associates the remission with the reduction of complications related to diabetes, this is an encouraging news for those who can achieve the remission of type 2 diabetes. Although the study alsoIt is a reminder that maintaining weight loss and remission is difficult, these findings suggest that any success with remission is associated with subsequent health benefits.
