减肥治愈某些2型糖尿病患者 Intentional weight loss gets type 2 diabetics into remission in some patients

Intentional weight loss gets type 2 diabetics into remission in some patients

Doctors may tell you that there is no cure for type 2 diabetes and you have to take medications to control your type 2 diabetes for the rest of your life.   Science has proved that that is false, at least for some diabetics.

The Diabetes Remission Clinical Trial  (DiRECT) released in 2017 showed that in some adult patients, type 2 diabetes can be reversed simply following an intensive weight management program.  But this study could not tell why some got cured while others were not.

Later, another study presented in 2018 at the European Association for the Study of Diabetes Annual Meeting in Berlin, Germany provides an explanation as to why some type 2 diabetes patients can be cured by losing weight but not others.

The study led by Professor Roy Taylor from Newcastle University in the UK indicates that those who had their disease diagnosed more recently were more likely to cure their type 2 diabetes by following a weight loss program.

For the 2017 study, 298 adults age 20 to 65 years who were diagnosed with type 2 diabetes in the past six years were divided into two groups, one participating in a weight management program and the other receiving no weight management intervention.

The weight management program included two parts, following a low calorie diet – about 830 kcal per day for three to five months, and then following a long term health food regimen to maintain the weight loss.

The researchers found 46% of type 2 diabetes patients in the intervention group achieved diabetes remission at the end of the one-year intervention, compared to only 4% in the control group.

In the 2018 study, Professor Taylor and colleagues examined fat content in the liver and pancreas, and beta-cell function in a subset of 58 participants in the weight program from the previous study including 40 responders (in remission) and 18 non-responders (not in remission) over 12 months.

Weight loss helps get rid of excessive fat around the liver and the pancreas and allow insulin-producing beta cells in the pancreas to be able to recover and function normally again.  That is, patients who responded to the weight loss program started producing insulin again.

Insulin is a hormone produced by beta cells in the pancreas that helps glucose in the blood enter cells in the muscle, fat, and liver to be used as a source of energy.

The finding challenges current medical consensus that beta-cell function is irreversibly lost in people with type 2 diabetes.

The researchers noticed that both responders and non-responders lost similar weight, 16.2 kg versus 13.4 kg.  They also noticed that those who had their type 2 diabetes cured had been living with the disease for a short period than those non-responders, 2.7 years versus 3.8 years.

“Our findings suggest that the longer someone has lived with type 2 diabetes, the less likely the function of their beta cell is likely to improve”, says Professor Taylor. “The clinical message is clear: the new effective weight loss approach should be advised for all with type 2 diabetes, especially at the time of diagnosis”.

Take-home message:

1) Type 2 diabetes patients should restrict their calorie intake immediately after their diagnosis with type 2 diabetes.  If they fail to cure their diabetes in the first few years, the beta cells in the pancreas may lose their vitality and may never recover their normal function.

2) Patients should keep in mind that doctors do not know everything about a disease, not to mention how to treat it.  In the past, they kept saying that liver cells and neurons cannot be regenerated.   Now science has proved they are wrong.  (Dr. Lu)