Health Care

Type 2 diabetes remission a 'practical target for primary care'

Type 2 diabetes remission a 'practical target for primary care'”

The Diabetes Remission Clinical Trial (DiRECT), funded by Diabetes UK and published today in the Lancet, found that after 12 months nearly half of participants had achieved remission to a non-diabetic state on an intensive calorie controlled programme that did not involve prescribing or increasing antidiabetes medication.

Almost half - 68 participants - had reversed their diabetes within one year of starting the trial, compared to six in the control group. Almost half the people who underwent the diet saw their condition go into remission - providing the strongest evidence yet that diabetes can be eradicated by simply losing weight.

Among those who lost 33Ibs or more, 86 per cent reversed their diabetes. Participants could not be taking insulin replacement and were taken off anti-diabetes drugs and anti-hypertensive medication.

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.

He added that Global Positioning System should encourage patients to lose weight as soon as possible after the condition is diagnosed.

Professor Lean added: "Putting type 2 diabetes into remission as early as possible after diagnosis could have extraordinary benefits, both for the individual and the NHS".

"DiRECT is telling us it could be possible for as many as half of patients to achieve this in routine primary care, and without drugs".

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. It can lead to serious and life-threatening complications, including blindness and foot amputations, heart and kidney disease. In Scotland alone, diabetes drugs are costing the NHS £90 million a year - up from £73.2m in 2012/13.

Prof Roy Taylor from Newcastle University, lead researcher in the trial funded by Diabetes UK, said: "These findings are very exciting".

Separately, another multi-centre randomly controlled trial called PREVIEW - Prevention of diabetes through lifestyle intervention of population studies in Europe and around the world - is looking at the use of very low energy diets to prevent people from becoming diabetic in the first place. "Bariatric surgery can achieve remission of diabetes in about three-quarters of people, but it is more expensive and risky, and is only available to a small number of patients".

A new study discovered that weight loss really can cure diabetes. "The big challenge is long-term avoidance of weight re-gain", he said.

A follow-up study over the next four years will determine whether weight loss and remission are achievable long-term. Professor Taylor said: 'Substantial weight loss results in reduced fat inside the liver and pancreas, allowing the organs to return to normal function'. But a year after starting the 850-calorie-a-day diet, 75 percent were drug free and 46 percent had seen their blood sugar drop so far they were no longer considered diabetic.

Dr Andrew Green, the BMA GP Committee's prescribing lead, welcomed the results.

'In the meantime, we need to stress to people with Type 2 diabetes the importance of speaking to their GP, and seeking their support, before trying any kind of low calorie diet'.



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