Type 2 diabetes isn’t necessarily for life, with a 2017 clinical trial providing some of the clearest evidence yet that the condition can be reversed, even in patients who have carried the disease for several years.
A clinical trial involving almost 300 people in the UK found an intensive weight management program put type 2 diabetes into remission for 86 percent of patients who lost 15 kilograms (33 lbs) or more.
“These findings are very exciting,” said diabetes researcher Roy Taylor from Newcastle University.
“They could revolutionise the way type 2 diabetes is treated.”
Taylor and fellow researchers studied 298 adults aged 20-65 years who had been diagnosed with type 2 diabetes within the previous six years to take part in the Diabetes Remission Clinical Trial (DiRECT).
Participants were randomly assigned to either an intensive weight management program or to regular diabetic care administered by their GP, acting as a control group.
For the 149 individuals placed in the weight management program, participants had to restrict themselves to a low calorie formula diet consisting of things like health shakes and soups, limiting them to consuming 825-853 calories per day for a period of three to five months.
After this, food was reintroduced to their diet slowly over two to eight weeks, and participants were given support to maintain their weight loss, including cognitive behavioural therapy and help with how to increase their level of physical activity.
Not an easy lifestyle change to adapt to, perhaps; but where there’s a will, there’s a way.
“We’ve found that people were really interested in this approach – almost a third of those who were asked to take part in the study agreed,” said nutritionist Mike Lean from the University of Glasgow.
“This is much higher than usual acceptance rates for diabetes clinical trials.”
For most of the people willing to make the sacrifices, the effort – based on the first year’s results, reported this week – was more than worth it.
Almost 90 percent of those who lost 15 kilograms (33 lbs) or more, successfully reversed their type 2 diabetes. More than half (57 percent) of those dropping 10 to 15 kilograms (22 to 33 lbs) achieved remission also.
For those who lost less weight – between 5 to 10 kilograms (11 to 22 lbs) – the reversal still worked for more than a third (34 percent) of participants.
When you consider that the control group receiving standard diabetic care management only saw a 4 percent remission rate, it’s clear that an interventionist weight loss strategy is a strong bet for type 2 diabetes patients who want to reverse their condition.
In the study, the average weight loss in the weight management group was 10 kilograms – whereas the control group participants only lost 1 kilogram.
Almost a quarter of the individuals in the weight management program achieved weight loss of 15 kilograms or more by 12 months, compared with none of the controls.
It’s worth noting that the vast majority of participants were white and British, so we should be cautious in assuming whether people from other backgrounds would see the same benefits from this kind of intervention.
Nonetheless, the researchers say their results show dietary intervention alone could help us revolutionise how we think about type 2 diabetes and its treatment, as it clearly isn’t the lifelong, chronic condition scientists once assumed it was.
Of course, the reversal isn’t permanent if people revert to unhealthy ways of eating – which in most cases would have contributed to their type 2 diagnosis in the first place.
As the DiRECT trial continues, it will be interesting to see just how many of the group can hold onto their weight loss success. For now at least, it’s clear that many lives have been changed.
“I had type 2 diabetes for two to three years before the study. I was on various medications which were constantly increasing and I was becoming more and more ill every day,” said 65-year-old Isobel Murray from North Ayrshire, who didn’t hesitate when she was invited to take part in the trial.
“When the doctors told me that my pancreas was working again, it felt fantastic, absolutely amazing. I don’t think of myself as a diabetic anymore… I am one of the lucky ones to have gone into remission.”
The findings were reported in The Lancet.
A version of this article was first published in December 2017.