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Study claims medical treatment can reverse type 2 diabetes

Intervention led to months of remission in 40% of trial participants

Adrian O'Dowd

Thursday, 16 March 2017

Type 2 diabetes might be reversible if patients receive intensive medical treatment using oral medications, insulin and lifestyle therapies, claims a study* published today in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

In the UK, there are currently an estimated 4.5 million people with diabetes – including one million people with type 2 diabetes who are not yet diagnosed – seen as an ongoing, chronic condition.

Canadian researchers studied ways of putting type 2 diabetes into remission by randomly dividing 83 individuals with the condition into three study groups.

Two of the groups received an intensive metabolic intervention where they were provided with a personalised exercise plan and a suggested meal plan that reduced their daily calorie intake by 500 to 750 calories a day.

These study participants met regularly with a nurse and dietitian to track their progress and received oral medications and insulin at bedtime to manage their blood glucose levels.

One group underwent the intervention for eight weeks, while the other was treated intensively for 16 weeks.

After the intervention, individuals in both groups stopped taking diabetes medications and were encouraged to continue with lifestyle changes.

The two intervention groups were compared to a control group of individuals also with type 2 diabetes.

Participants in this group received standard blood sugar management advice from their usual healthcare provider for the duration of the trial and received standard lifestyle advice.

The researchers measured the study participants’ average blood glucose levels from the past two to three months using a HbA1C blood test at eight, 20, 28 and 52 weeks to gauge how well their blood sugar was controlled. They also carried out oral glucose tolerance tests.

Results showed that three months after the intervention was completed, 11 out of 27 individuals in the 16-week intervention group met HbA1C criteria for complete or partial diabetes remission, compared to four out of 28 individuals in the control group.

Three months after finishing the eight-week intervention, six out of 28 individuals in that group met the same criteria for complete or partial diabetes remission.

The study's first author, Dr Natalia McInnes, of McMaster University and Hamilton Health Sciences, in Ontario, Canada, said: “By using a combination of oral medications, insulin and lifestyle therapies to treat patients intensively for two to four months, we found that up to 40% of participants were able to stay in remission three months after stopping diabetes medications.

“The research might shift the paradigm of treating diabetes from simply controlling glucose to an approach where we induce remission and then monitor patients for any signs of relapse.”

The senior investigator on the trial, Dr Hertzel Gerstein, of McMaster University and Hamilton Health Sciences, added: “We chose to use metformin, acarbose and basal insulin glargine in this trial as these medications have all been shown to slow or prevent the development of type 2 diabetes.

“However, other drug combinations could lead to higher remission rates and need to be systematically studied with regard to this outcome.”

Emily Burns, research communications manager for Diabetes UK, said: “We know that diet, exercise and medications can help people with type 2 diabetes to manage their condition.

“We’re starting to see mounting evidence that putting type 2 diabetes into remission is feasible as well. This is really interesting research, but we need longer trials in larger numbers of people to see if their approach works for the long-term.”

* McInnes N, Smith A, Otto R, et al. Piloting a Remission Strategy in Type 2 Diabetes: Results of a Randomized Controlled Trial. J Clin Endocrinol Metab jc.2016-3373. DOI: 10.1210/jc.2016-3373

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