In 2017, the historic clinical essay of diabetes remission (Direct) revealed that type 2 diabetes can be reversed in some adults following an intensive weight loss program, but nobody knew why.Now, a new investigation presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Berlin, suggests that the remission depends on whether the Beta cells of insulin producers in the pancreas can recover and work normally.
The finding challenges the current medical consensus that the function of beta cells is irreversibly lost in people with type 2 diabetes.
The study led by Professor Roy Taylor at the University of Newcastle in the United Kingdom provides more evidence that weight loss around the liver and the pancreas is key to remission of type 2 diabetes, but suggests that remission can only be achievedIf it improves the function of pancreatic beta cells so that they can restart their insulin production.Insulin is a hormone produced by beta cells in the pancreas that helps blood glucose to enter muscle cells, fat and liver to use it as energy.
The Direct trial included 298 adults between 20 and 65 who had been diagnosed with type 2 diabetes in the last 6 years.The study, published in The Lancet in 2017, examined whether a new weight control program consists of a low-calorie diet (825-853 kcal / day for 3-5 months), followed by the reintroduction of healthy foods and support for support tolong term to maintain weight loss.The results showed that almost half of the participants (46%) who followed the weight control program achieved the remission of diabetes per year compared, compared to six (4%) in the control group.
In this new study, Professor Taylor and his colleagues investigated exactly how weight loss can put type 2 diabetes in remission and why it works for some people and not for others.They examined the fat content in the liver and pancreas, and the function of beta cells in a subset of 58 direct participants, including 40 responders (people in remission) and 18 non -responders (people without remission) for 12 months.The responders had been living with type 2 diabetes for less time than those who did not respond (average of 2.7 years vs. 3.8 years).
During the study period, both groups lost a similar amount of weight (16.2 kg for responders Vs. 13.4 kg for those who did not respond), which led to similar reductions in the fat content in the liver and pancreas and the pancreas and the pancreas andAverage triglycerid concentrations.
However, only responders showed an early and sustained improvement in the function of beta cells.After losing weight, the beta cells of people in remission began to function properly again, but there was no change in the amount of insulin produced by those who did not respond.
"Our findings suggest that the longer someone has lived with type 2 diabetes, it is less likely that the function of their beta cell improves," says Professor Taylor."The clinical message is clear: the new effective weight loss approach must be recommended for all with type 2 diabetes, especially at the time of diagnosis."
The authors recognize several limitations, including that most participants were white and British, so the results could be less generalizable to other racial and ethnic groups, which tend to develop diabetes with less weight gain.They also point out that participants were only evaluated for 12 months and that a longer term monitoring is being carried out.