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Weight loss can reverse type 2 diabetes

07 December 2017

The first-year results of a clinical trial have shown that nearly half of people partaking in an intensive weight management program delivered through primary care achieved remission of their type 2 diabetes without medication.

A new study from Newcastle and Glasgow Universities shows that the disease can be reversed by losing weight, so that sufferers no longer have to take medication and are free of the symptoms and risks.

The team previously confirmed that Type 2 diabetes is caused by excess fat within the liver and pancreas, and that consuming a very low calorie diet could restore normal glucose.

"These findings are very exciting", Taylor told Science Alert.

An accompanying commentary backed the researchers' argument that weight loss ought to be the primary goal in the treatment of type 2 diabetes. Type 2 diabetes is a chronic condition that affects how a person's body metabolizes sugar, either because they've developed resistance to the hormone insulin, or their pancreas fails to produce enough insulin. This is expected to climb to 642 million by 2040. In Scotland alone, diabetes drugs are costing the NHS £90 million a year - up from £73.2m in 2012/13.

Type 2 diabetes is usually treated with medication and in some cases, bariatric surgery to restrict stomach capacity, which has also been shown to reverse the disease. "Diet and lifestyle are touched upon, but diabetes remission by cutting calories is rarely discussed", said Taylor. Practices were randomly assigned to provide either the weight management programme delivered by practice dietitians or nurses, or standard best practice GP care under current guidelines.

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Prof Taylor said that while bariatric surgery such as gastric bands would reverse diabetes in around three-quarters of patients, it was "more expensive and risky, and is only available to a small number of patients". Half of the patients were put on a low-calorie diet and lost an average of 10 to 15 kg (22 to 33 pounds).

The trial, done at the Magnetic Resonance Center at Newcastle University in the United Kingdom, looked at 306 participants recently diagnosed with type 2 diabetes in the last six years.

Half of the patients in the study went on a 6-month diet plan, while the other half did not.

Forty-six per cent of those in the weight programme went into remission. The other half were taken off drugs and put on a strict diet of no more than 853 calories a day for three months, eating only diet shakes or soups. The participants were all given support throughout, including cognitive behavior therapy and were encouraged to exercise.

However, this new study is the first to demonstrate that a weight management programme can achieve remission of Type 2 diabetes in routine primary care. Taylor stresses that the study only addressed people diagnosed relatively recently - within the past six years - and that the effect may not apply to more long-term patients. "With knowledge of remarkable results from this study, we could remove "Diabetic for life" label from many patients", said Dr Anoop Misra, chairman, Fortis C-doc hospital for diabetes.

"When the doctors told me that my pancreas was working again, it felt fantastic, absolutely wonderful". The Diabetes Prevention Program in the USA revealed in 2002 that diet and exercise alone can prevent people from progressing from pre-diabetes to diabetes, in some cases better than medications created to control blood sugar. "The big challenge is longterm avoidance of weight regain", he added.

Weight loss can reverse type 2 diabetes