In a nutshell
The aim of this study was to assess the remission of type 2 diabetes (T2D) during a family doctor-led weight management programme. The main finding of the study was that after 2 years of the programme more than one-third of patients had reversed their T2D.
Some background
The number of people with T2D is increasing. One factor is the increasing rate of obesity. With high body fat levels, fat gets deposited on the liver and the pancreas (the organ that controls blood sugar). Therefore, the body can no longer control blood sugar. T2D has devastating complications such as eye disease (which can result in blindness), kidney disease and foot ulcers (which can result in amputations).
Studies have shown that weight loss of at least 10-15kg can reverse T2D for people who have only had T2D for a short time. However, weight loss can be difficult without guidance and support. It is possible for family doctors (general practitioners, primary care doctors) to provide this guidance and support with a weight management programme. The effectiveness of a family doctor-led weight management programme in the reversal of T2D is unknown.
Methods & findings
This study included 298 patients with T2D. 149 (50%) of these patients took part in a 2-year weight management programme (WMP) that was led by a family doctor. The programme involved stopping anti-diabetic and blood pressure medications, diet intervention and support for weight loss maintenance. The other 50% of patients received standard diabetes care (STD) with no change to medications, diet or exercise.
After 1 year, 46% of the WMP group were in remission from their T2D. 24% of the WMP group had lost at least 15kg body weight. Remission was defined as a HbA1c (blood test measuring blood sugar control over the last 3 months) level of less than 6.5% after stopping diabetes medication.
After 2 years, 11% of the WMP group had lost at least 15kg body weight compared to 2% of the STD group. 36% of the WMP group were in remission from their T2D compared to 3% of the STD group.
The bottom line
The authors concluded that a weight management programme led by a family doctor reversed T2D in more than one third of patients.
The fine print
This study had a very small number of participants. Larger studies over longer periods of time are needed for more solid evidence.
Published By :
The lancet. Diabetes & endocrinology
Date :
Mar 05, 2019
