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Type 2 Diabetes Remission

'more People Need To Know Type 2 Diabetes Is Reversible' Argues Report

'more People Need To Know Type 2 Diabetes Is Reversible' Argues Report

What is the issue? "Type 2 diabetes could be beaten into remission if patients shed around 15kg, [2.4 stones]," reports BBC News. In the past type 2 diabetes was thought to be a lifelong condition. There is increasing evidence that even if it can't be cured, it is possible to put the condition into remission through weight loss. A pressing problem is, as The Daily Telegraph reports, that "less than 1 in 1,000 people" achieve remission. Achieving weight loss through a combination of diet and exercise could mean that you do not have to start taking medication for type 2 diabetes. What is diabetes remission? Type 2 diabetes means the body can no longer maintain healthy blood sugar levels through production of the hormone insulin. When average blood sugar rises to harmful levels (usually described as 6.5% or 48mmol/moll HbA1c, a measure of long-term blood sugar control), people are diagnosed with diabetes. While improved diet and exercise is recommended, most people with diabetes are treated with anti-diabetic medicines to manage their blood sugar. The aim is to prevent the development of complications such as heart disease, leg ulcers and eye damage. Although many factors affect the development of type 2 diabetes, it often accompanies weight gain. In recent years, doctors have noticed that some obese patients who lose a lot of weight, whether through very low calorie diets or weight loss surgery, have blood sugar levels that drop back to normal, and stay that way without diabetes medicines. This has fueled interest in "reversing" diabetes through major weight loss. Instead of curing diabetes, doctors talk about diabetes being "in remission". This is because it can be a two-way process – if people put weight back on, they may become diabetic again. What is the basis for t Continue reading >>

Can A Crash Diet Put Diabetes Into Remission?

Can A Crash Diet Put Diabetes Into Remission?

A study finds evidence that exercise and diet can put type 2 diabetes into remission. Here’s how it works. Diabetes now affects more than 30 million adults in the United States. The disease increases the risk of cardiovascular disease, nerve damage, and kidney damage for those who have it. But what if a medically supervised crash diet could help put this chronic condition in remission? Experts in the United Kingdom are looking into whether a strict diet program — a kind of crash diet — can put this normally chronic condition into remission. A diet to stop diabetes To study this treatment, researchers from Newcastle University and the University of Glasgow studied 306 people between the ages of 20 to 65. The participants had been diagnosed with type 2 diabetes within the past six years, were overweight, and hadn’t started to use insulin. About half the participants were put into a weight loss program. The other half received normal diabetes care with their general practitioner or primary care physician. The weight loss program study was called DiRECT, the Diabetes Remission Clinical Trial. The regimen is a low-calorie diet via shakes and soups for a period of weeks, and then a gradual reintroduction of normal foods. No exercise was recommended in the beginning of the study. It was introduced as the participants worked to maintain their weight loss. After one year, the researchers found that nearly half of the participants in the weight loss program went into remission from diabetes. In the group that received normal diabetes care, just six participants went into remission. Remission was defined as having blood sugar levels below 6.5 percent and being off all diabetes medication for at least two months. More than half — 57 percent — of participants who lost a Continue reading >>

Study Suggests Type 2 Diabetes Remission Possible With Very Low-calorie Diet

Study Suggests Type 2 Diabetes Remission Possible With Very Low-calorie Diet

New research published in Diabetes Care suggests that a very low-carlorie diet can help adults with type 2 diabetes “reverse” their diabetes. Those who keep their weight down remained free of diabetes. Researchers at Newcastle University in the United Kingdom evaluated 30 adults with type 2 diabetes who followed a low-cal diet for 8 weeks, totally a mere 624 to 700 calories per day. While substantial weight loss can be achieved through a very low-cal diet, the study had participants only eating three shakes and nonstarchy vegetables. “What we have shown is that it is possible to reverse your diabetes, even if you have had the condition for a long time, up to around 10 years,” Roy Taylor, MD, FRCP, professor of medicine and metabolism at Newcastle University in the United Kingdom, said in a press release. “If you had the diagnosis for longer than that, then don’t give up hope — major improvement in blood sugar control is possible.” However, only forty percent of participants were considered responders to the diet. Compared to the nonresponders, responders were diagnosed more recently, and had a lower fasting glucose and HbA1c at baseline. A1C in non responders dropped an average of 8.4% to 8%, while responders saw their A1C drop from 7.1% to 5.8%. “Substantial weight loss can be achieved only by severe calorie restriction….The transition from low-calorie liquid diet to normal eating requires very careful management. This two-step approach to substantial weight loss is successful, unlike current beliefs about how to lose weight,” explains Dr. Taylor. Other researchers in the field of type 2 diabetes are less confident in the results. “The fact that a low-calorie diet can reverse diabetes is something we’ve known a long time….The key issue here Continue reading >>

Primary Care-led Weight Management For Remission Of Type 2 Diabetes (direct): An Open-label, Cluster-randomised Trial

Primary Care-led Weight Management For Remission Of Type 2 Diabetes (direct): An Open-label, Cluster-randomised Trial

Summary Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700). Participants, carers, and research assistants who collected outcome data were aware of group allocation; however, allocation was concealed from the study statistician. We recruited individuals aged 20–65 years who had been diagnosed with type 2 diabetes within the past 6 years, had a body-mass index of 27–45 kg/m2, and were not receiving insulin. The intervention comprised withdrawal of antidiabetic and antihypertensive drugs, total diet replacement (825–853 kcal/day formula diet for 3–5 months), stepped food reintroduction (2–8 weeks), and structured support for long-term weight loss maintenance. Co-primary outcomes were weight loss of 15 kg or more, and remission of diabetes, defined as glycated haemoglobin (HbA1c) of less than 6·5% (<48 mmol/mol) after at least 2 months off all antidiabetic medications, from baseline to 12 months. These outcomes were analysed hierarchically. This trial is registered with the ISRCTN registry, number 03267836. Between July 25, 2014, and Aug 5, 2017, we recruited 306 individuals from 49 intervention (n=23) and control (n=26) general practices; 149 participants per group comprised the intention-to-treat population. Continue reading >>

Type 2 Diabetes Remission With Intensive Treatment

Type 2 Diabetes Remission With Intensive Treatment

Theory proposed that type 2 diabetes can be reversed in the short term with medical approaches over bariatric surgeries. Type 2 diabetes can be acquired over time when a person makes poor lifestyle choices with their diet and lives a sedentary lifestyle. Eventually, it progresses to a chronic state with additional complications, but it can be reversed with lifestyle approaches and a series of oral and injectable medications. According to the Society’s Endocrine Facts and Figures, one in 10 American adults has type 2 diabetes and either cannot produce enough insulin or their pancreas is not making insulin efficiently. Thus, resulting in an increase in blood sugar and keeping the cells from receiving energy. Ongoing studies have stressed treating type 2 diabetes by reversing the disease rather than controlling its progression by achieving normoglycemia. Recent studies show that intensive medical treatment for two to four months, using oral medications, insulin and lifestyle therapies may help reverse type 2 diabetes. In an open-labeled, parallel, randomized pilot trial, a short-term intensive metabolic approach was conducted to target the fasting and postprandial normoglycemia and weight loss using a combination of pharmacological and lifestyle approaches to induce sustained diabetes remission. The objective of the study was to assess the feasibility, safety, and potential to induce remission of a short-term intensive metabolic strategy. All analyses were performed using the intention-to-treat principle. A chi-square test and two sample t-test was used to compare dichotomous and continuous outcomes, respectively. The interventional, phase-4 study enrolled 83 participants with type 2 diabetes for up to three years of duration that were followed for 52 weeks. Participants Continue reading >>

Liquid, Low-calorie Diet Can Put Diabetes In Remission, Study Finds

Liquid, Low-calorie Diet Can Put Diabetes In Remission, Study Finds

Scientists In Texas Closer To Diabetes Cure With Unconventional Treatment Liquid, low-calorie diet can put diabetes in remission, study finds Najja Parker , The Atlanta Journal-Constitution Struggling with Type 2 diabetes? A rigorous diet could help put it in remission, according to a new report. RELATED: Scientists may have found a way to reverse type 2 diabetes Researchers from Scotland recently conducted an experiment, published in The Lancet journal, to determine how a low-calorie diet can affect the disease. To do so, they examined 149 individuals whod been living with Type 2 diabetes for up to six years. Those subjects underwent a liquid diet, which included four 200-calorie meals, for three to five months. Scientists then reintroduced them to solid foods and helped them maintain a structured diet for the rest of the yearlong study. The participants were not asked to adjust their exercise routine, and all antidiabetic and blood pressure-lowering drugs were stopped. After analyzing the results, they found that about half of the participants were able to get their diabetes into remission. Furthermore, the people in the study lost an average of 20 pounds. RELATED: Study: Broccoli extract lowers blood sugar for type 2 diabetes patient "Our findings suggest that even if you have had type 2 diabetes for 6 years, putting the disease into remission is feasible", co-author Michael Lean said in a statement . "In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimise individual results." While they noted 32 people dropped out of the program, they believe their findings are promising and prove to be an effective way to combat the disease. "Rather than addressing the root caus Continue reading >>

Type 2 Diabetes Is 'reversible Through Weight Loss'

Type 2 Diabetes Is 'reversible Through Weight Loss'

Many doctors and patients do not realize that weight loss can reverse type 2 diabetes. Instead, there is a widespread belief that the disease is "progressive and incurable," according to a new report published in the BMJ. This is despite there being "consistent evidence" that shedding around 33 pounds (15 kilograms) often produces "total remission" of type 2 diabetes, note Prof. Mike E. J. Lean and other researchers from the University of Glasgow in the United Kingdom. The thrust of their paper is that greater awareness, when combined with better recording and monitoring of remissions, could result in many more patients no longer having to live with type 2 diabetes and a massive reduction in healthcare costs. The global burden of type 2 diabetes has nearly quadrupled over the past 35 years. In 1980, there were around 108 million people with the disease, and by 2014, this number had risen to 422 million. The vast majority of diabetes cases are type 2 diabetes, which is a disease that results when the body becomes less effective at using insulin to help cells to convert blood sugar, or glucose, into energy. Excess body weight is a main cause of this type of diabetes. In the United States, an estimated 30.3 million people, or around 9.4 percent of the population, have diabetes - including around 7.2 million who do not realize it. Diabetes accounts for a high portion of the national bill for taking care of the sick. The total direct and indirect cost of diagnosed diabetes in the U.S. was estimated to be $245 billion in 2012. In that year, of the $13,700 average medical spend for people with diagnosed diabetes, more than half (around $7,900) was directly attributed to the disease. Treatment 'focuses on drugs' Prof. Lean and colleagues note that the current management guideli Continue reading >>

Remission Of Type 2 Diabetes With A Primary Care–based Weight-loss Program

Remission Of Type 2 Diabetes With A Primary Care–based Weight-loss Program

This article requires a subscription for full access. NEJM Journal Watch articles published within the last six months are available to subscribers only. Articles published more than 6 months ago are available to registered users. Continue reading >>

How Do We Define Cure Of Diabetes?

How Do We Define Cure Of Diabetes?

The mission of the American Diabetes Association is “to prevent and cure diabetes and to improve the lives of all people affected by diabetes.” Increasingly, scientific and medical articles (1) and commentaries (2) about diabetes interventions use the terms “remission” and “cure” as possible outcomes. Several approved or experimental treatments for type 1 and type 2 diabetes (e.g., pancreas or islet transplants, immunomodulation, bariatric/metabolic surgery) are of curative intent or have been portrayed in the media as a possible cure. However, defining remission or cure of diabetes is not as straightforward as it may seem. Unlike “dichotomous” diseases such as many malignancies, diabetes is defined by hyperglycemia, which exists on a continuum and may be impacted over a short time frame by everyday treatment or events (medications, diet, activity, intercurrent illness). The distinction between successful treatment and cure is blurred in the case of diabetes. Presumably improved or normalized glycemia must be part of the definition of remission or cure. Glycemic measures below diagnostic cut points for diabetes can occur with ongoing medications (e.g., antihyperglycemic drugs, immunosuppressive medications after a transplant), major efforts at lifestyle change, a history of bariatric/metabolic surgery, or ongoing procedures (such as repeated replacements of endoluminal devices). Do we use the terms remission or cure for all patients with normal glycemic measures, regardless of how this is achieved? A consensus group comprised of experts in pediatric and adult endocrinology, diabetes education, transplantation, metabolism, bariatric/metabolic surgery, and (for another perspective) hematology-oncology met in June 2009 to discuss these issues. The group con Continue reading >>

This Extreme Diet Reversed Type 2 Diabetes In Up To 86% Of Patients

This Extreme Diet Reversed Type 2 Diabetes In Up To 86% Of Patients

Type 2 diabetes isn't necessarily for life, with a new 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," says 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," says nutritionist Mike Lean from the University of Glasgow. "This is much higher than usu Continue reading >>

Type 2 Diabetes ‘can Be Put Into Remission With All Liquid Low-calorie Diet’

Type 2 Diabetes ‘can Be Put Into Remission With All Liquid Low-calorie Diet’

The most common form of diabetes could be put into remission with a low calorie all liquid diet, a landmark trial has found. Around half of those with Type 2 diabetes went into remission after 12 months using an intensive low calorie diet of soups and shakes and no medication, according to the trial. Around 300 people in Scotland and Tyneside took part in the Diabetes Remission Clinical Trial, funded by Diabetes UK. Half received standard care from their GP, while the other half received a structured weight management programme. Findings from the first year showed that almost half (46 per cent) of those who took part in the diet programme were in remission after 12 months. “We’re very encouraged by these initial results, and the building of robust evidence that remission could be achievable for some people.” Dr Elizabeth Robertson, Director of Research, Diabetes UK Isobel Murray, 65, from North Ayrshire, who took part in the study, lost more than 22kg and no longer needs diabetes medication. “I was on various medications which were constantly increasing and I was becoming more and more ill every day,” she said. “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 any more. I get all my diabetes checks done, but I don’t feel like a diabetic.” There is an estimated 4.5 million people with diabetes in the UK – almost 1 in 10 adults – which costs the NHS around £14 billion a year. The vast majority have Type 2 diabetes, which is strongly linked to lifestyle – poor diet, excess weight and inactivity – as well as genetics. It is a life-changing condition that progresses over time, which can have devastating consequences, such as cardiovascular disease, kidney disea Continue reading >>

A New Clue About What Helps Put Diabetes Into Remission Following Weight Loss Surgery

A New Clue About What Helps Put Diabetes Into Remission Following Weight Loss Surgery

With commentary by lead researcher Flemming Dela, MD, of the Center for Healthy Aging and Department of Biomedical Science at the University of Copenhagen. Weight loss surgery can send type 2 diabetes into remission for years, meaning no more blood-sugar drugs. But for some, diabetes returns. Now, a recent Danish study suggests a way to predict long-term success before surgery: By testing the health of insulin-producing beta cells. In a small but well-designed study published in The Journal of Physiology, scientists measured insulin output before and after Roux-en-Y gastric bypass surgery in 18 people with type 2 diabetes and in 15 people without diabetes. Four months later, 57% of the type 2’s with the healthiest beta cells no longer had diabetes compared to none of those with poor-performing cells. After 18 months, diabetes was in remission for 71% of those with the best-functioning beta cells but just 38% with the poorest-producing cells. "Our study shows that the patients’ ability to produce insulin is decisive for whether or not the procedure eliminates diabetes,” says lead researcher Flemming Dela, MD, of the Center for Healthy Aging and Department of Biomedical Science at the University of Copenhagen. “Measuring the insulin cells’ performance before surgery can thus provide us with a much better basis from which to predict who will actually benefit from the surgery.” The Mystery of Remission Remission in this study meant an A1C below 6%, fasting blood sugar levels below 102.6 mg/dL and no need for diabetes medications anymore. Remission rates in the months after weight loss surgeries like gastric bypass and sleeve gastrectomy are often high. In a 2009 University of Minnesota review of studies involving more than 7,000 type 2s, 80% saw diabetes resolve Continue reading >>

Radical Diet Can Reverse Type 2 Diabetes, New Study Shows

Radical Diet Can Reverse Type 2 Diabetes, New Study Shows

A radical low-calorie diet can reverse type 2 diabetes, even six years into the disease, a new study has found. The number of cases of type 2 diabetes is soaring, related to the obesity epidemic. Fat accumulated in the abdomen prevents the proper function of the pancreas. It can lead to serious and life-threatening complications, including blindness and foot amputations, heart and kidney disease. 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. Nine out of 10 people in the trial who lost 15kg (two-and-a-half stone) or more put their type 2 diabetes into remission. Prof Roy Taylor from Newcastle University, lead researcher in the trial funded by Diabetes UK, said: “These findings are very exciting. They could revolutionise the way type 2 diabetes is treated. This builds on the work into the underlying cause of the condition, so that we can target management effectively. “Substantial weight loss results in reduced fat inside the liver and pancreas, allowing these organs to return to normal function. What we’re seeing … is that losing weight isn’t just linked to better management of type 2 diabetes: significant weight loss could actually result in lasting remission.” Worldwide, the number of people with type 2 diabetes has quadrupled over 35 years, rising from 108 million in 1980 to 422 million in 2014. This is expected to climb to 642 million by 2040. Type 2 diabetes affects almost 1 in 10 adults in the UK and costs the NHS about £14bn a year. 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. Continue reading >>

Rigorous Diet Can Put Type 2 Diabetes Into Remission, Study Finds

Rigorous Diet Can Put Type 2 Diabetes Into Remission, Study Finds

Some people with Type 2 diabetes were able to put the disease in remission without medication by following a rigorous diet plan, according to a study published today in the Lancet medical journal. "Our findings suggest that even if you have had Type 2 diabetes for six years, putting the disease into remission is feasible," Michael Lean, a professor from the University of Glasgow in Scotland who co-led the study, said in a statement. The researchers looked at 149 participants who have had Type 2 diabetes for up to six years and monitored them closely as they underwent a liquid diet that provided only 825 to 853 calories per day for three to five months. The participants were then reintroduced to solid food and maintained a structured diet until the end of the yearlong study. The researchers found that almost half of the participants (68 total) were able to put their diabetes in remission without the use of medication after one year. In addition, those who undertook the study also lost an average of more than 20 pounds. Thirty-two of the 149 participants in the study, however, dropped out of the program. The study comes at a time when more than 100 million American adults are living with diabetes or prediabetes, according to a report released earlier this year by the U.S. Centers for Disease Control and Prevention. Prediabetes was defined by the CDC as a condition that if not treated often leads to Type 2 diabetes within five years. In addition, approximately 90 to 95 percent of the more than 30 million Americans living with diabetes have Type 2 diabetes, according to the CDC. Roy Taylor, a professor at Newcastle University in the U.K. who co-led the study said in a statement announcing the findings that the impact that diet and lifestyle has on diabetes are "rarely discu Continue reading >>

Beating Type 2 Diabetes Into Remission

Beating Type 2 Diabetes Into Remission

Recognising and accurately coding reversal of type 2 diabetes is key to improving outcomes and reducing healthcare costs, argue Louise McCombie and colleagues Type 2 diabetes, generally perceived as progressive and incurable, now affects 5-10% of the population, about 3.2 million people in the UK.1 Until complications develop, most patients are managed entirely within primary care, with diabetes comprising a major part of general practice activity. About 10% of total UK NHS expenditure goes on treating diabetes, and international figures suggest that medical costs for people with diabetes are twofold to threefold greater than the average for age and sex matched people without diabetes.1 Application of current clinical guidelines to reduce glycated haemoglobin (HbA1c) levels and cardiovascular risks, primarily with drugs and generic lifestyle advice, has improved clinical outcomes, but many patients still develop vascular complications, and life expectancy remains up to six years shorter than in people without diabetes.2 The diagnosis carries important social and financial penalties for individuals, as well as poor health prospects. Remission of diabetes (no longer having diabetes, at least for a period) is clearly attainable for some, possibly many, patients but is currently very rarely achieved or recorded. Greater awareness, documentation, and surveillance of remissions should improve health outcomes and reduce healthcare costs. Changing management In keeping with trends in most medical specialties, diabetes management is beginning to focus on reversible underlying disease mechanisms rather than treating symptoms and subsequent multisystem pathological consequences.34 Both (epi)genetic predisposition and ageing have a role in type 2 diabetes, but it is rare without we Continue reading >>

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