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Posted by on Dec 18, 2017 in Diabetes mellitus | 0 comments

In a nutshell

This study examined the effectiveness of a weight-loss program (run in primary-care settings) on type 2 diabetes patients. The authors found that almost half of those who sustained their weight-loss were able to reverse their diabetes.

Some background

Many people with type 2 diabetes (T2D) are at risk of complications and/or may have a reduced lifespan. Some studies have indicated that those who have had diabetes for a short time (e.g. under six years) may be able to reverse their diagnosis by losing weight. This is called diabetes remission. Previous studies have demonstrated that many T2D patients can enter remission on a short-term basis (e.g. weeks to a few months). The effect of such weight loss on preventing return of T2D in the long-term is, however, less clear.

Methods & findings

This study examined the effects of a primary-care-led, weight-loss program on T2D remission. All patients included had been diagnosed with T2D less than six years prior to the study-date. 149 T2D patients underwent the program for a year (Group A).  149 other patients received standard care (Group B). To lose weight, group A received a low-calorie (825-853 kcal / day) formula diet for 3-5 months. This was followed by a stepped food reintroduction for 2-8 weeks, complemented by structured weight-loss support. All of group A also had to stop using anti-diabetic and anti-high-blood-pressure medication. Diabetes remission was defined as an HbA1C (average blood glucose over 3 months) of less than 6.5% after twelve months. 

At twelve months, 24% of Group A achieved a 15-kg weight loss (compared to 0% in Group B). 46% of Group A achieved diabetes-remission (compared to 4% in Group B). Remission was closely related to the degree of weight-loss maintained at 12 months. Remission was acheived in 86% of participants with at least 15 kg weight-loss and 57% of those with weight-loss between 10 and 15 kg. Quality of life scores increased for Group A and decreased in Group B. 

The bottom line

The authors concluded that type 2 diabetes of up to six years' duration can potentially be reversed through an appropriate weight-loss program. 

The fine print

The majority of people in this study were Caucasian. More reserach needs to be carried-out to investigate the effects of such a weight-loss program on other ethnicities; this is particularly true for Asian patients, who tend to develop diabetes with less weight gain.
Published By :

Lancet (London, England)

Date :

Dec 04, 2017

Original Title :

Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.

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