For years, studies have looked at ways to prevent Type 2 (adult onset) diabetes, and have identified a healthy diet and exercise can prevent it…but what about those who already have it? A new study suggests that it may be possible to reverse this destructive disease in the early stages, at least temporarily. This is important, given that treatments for diabetes lose their effectiveness over time, creating an ongoing struggle with gradually increasing medication to keep blood sugar levels under control.
People with type 2 diabetes were signed up to either an 8-week or 16-week intensive treatment program, or to usual care. The treatment included intensive lifestyle counselling (targeting weight loss) with frequent nurse and dietician contact, and treatment with insulin, metformin (a drug that increases sensitivity to insulin) and acarbose (a medicine that slows the breakdown of carbohydrates into sugar in the digestive system). The goal was to have blood glucose of less than 5.4mmol/l before meals and an average after meal glucose of less than 6.8mmol/ after 8 or 16 weeks.
Half of people in the 8-week group achieved these goals compared to only 3.6% of the control group, and 70% of the 16-week group reached the targets. The drugs were then discontinued in the treatment groups and their blood sugar was monitored.
What was really interesting, was that some people in the treatment groups continued to maintain blood glucose control even after the drugs and insulin were discontinued. Twelve weeks after the completion of the intervention, 21.4% of the 8-week group and 40.7% of the 16-week group met criteria for complete or partial diabetes remission, compared to only 10.7% of “controls” who had received only the usual care.
These results suggest that an intensive diabetes treatment strategy delivered over 2 to 4 months may induce remission of type 2 diabetes. Of course, further research needs to be done in the area to confirm the results, especially as this was only a short-term study, but it's encouraging to see that the effects of 8 to 16 weeks of treatment can continue for several months, at least in some people with diabetes.
Since the intervention also intensively targeted lifestyle and weight loss, the remission of diabetes could be due at least in part to these factors; I would like to have seen a comparison of drug intervention with an intensive lifestyle and weight loss group rather than only with usual care. However, any study into possible ways to reverse diabetes is valuable, given the increasing rates of diabetes that are occurring now.
This study was published in the Journal of Clinical Endocrinology and Metabolism on March 15, 2017 (N.McInnes, et al; Piloting a Remission Strategy in Type 2 Diabetes: Results of a Randomized Controlled Trial).
