Researchers at McMaster University and Hamilton Health Sciences in Ontario examined 83 patients with Type 2 diabetes and stratified them into three groups. Two groups received intensive metabolic intervention that featured a personalized workout plan and a suggested meal plan designed to cut their daily calorie intake by 500 to 750 calories a day. Both groups had regular appointments to a nurse of dietitian to monitor their progress, and took oral drugs and insulin at bedtime to maintain ideal blood sugar levels. One group underwent the intervention for eight weeks, while the other for 16 weeks. Both groups stopped taking diabetes drugs after the intervention, and were encouraged to continue with the lifestyle changes. On the other hand, the third control group received standard blood sugar management and lifestyle advice from their usual health care providers throughout the trial period. Participants in all three groups received standard diabetes care if disease relapse was observed. The participant’s blood sugar levels from the previous two to three months were measured at eight, 20, 28, and 52 weeks to monitor their progress. The participants also underwent oral glucose tolerance tests.
Research data shows that 11 out of 27 participants in the 16-week intervention group met the criteria for complete or partial diabetes remission at three months after the intervention. Six out of 28 participants in the eight-week intervention were also able to meet the criteria for partial or complete diabetes remission during the same period. In contrast, only four of 28 participants in the control group were able to meet the criteria at three months following the intervention.
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The findings demonstrated that intensive diabetes treatment through oral drugs, insulin, and lifestyle therapy for two to four months is able to induce remission in 40 percent of patients at three months after stopping diabetes medications. The results establish that Type 2 diabetes can be reversed in the short term, not only through bariatric surgery but by medical approaches as well, a study co-author said.
“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 idea of reversing the disease is very appealing to individuals with diabetes. It motivates them to make significant lifestyle changes and to achieve normal glucose levels with the help of medications. This likely gives pancreas a rest and decreases fat stores in the body, which in turn improves insulin production and effectiveness,” said study co-author Natalia McInnes.
The researchers used metformin, acarbose, and basal insulin glargine in this study. These drugs were shown to slow or prevent the onset of Type 2 diabetes. However, other drug combinations may result in higher rates of remission, and require further assessment, the study’s senior researcher said.
Significantly few participants remained in remission after a year. Remission rates between the intervention group and the controls did not appear to be different at 52 weeks after the treatment, which indicates that the effects were not sustained. “If you don’t sustain the lifestyle intervention, then the disease is going to come back,” said Dr. Philip Kern, Professor of Endocrinology at the University of Kentucky in Lexington.
Data from the International Diabetes Federation (IDF) reveals that 415 million people worldwide are diagnosed with diabetes; a rate that may skyrocket to 642 million in 2040. Diabetes accounts for five million deaths worldwide. IDF data also reveals that global expenditure on diabetes totaled $673 billion in 2015, which accounts to 12 percent of the total global health expenses. Three out of four people with diabetes reside in low- and middle-income countries.