People who achieve weight loss of 10% or more in the first five years following diagnosis with type 2 diabetes have the greatest chance of seeing their disease go into remission, according to a study led by the University of Cambridge.
The findings suggest that it is possible to recover from the disease without intensive lifestyle interventions or extreme calorie restrictions.
Type 2 diabetes affects 400 million people worldwide and increases the risk of heart disease, stroke, blindness and amputations. While the disease can be managed through a combination of positive lifestyle changes and medication, it is also possible for the high blood glucose levels that define diabetes to return to normal - through significant calorie restriction and weight loss. An intensive low-calorie diet involving a total daily intake of 700 calories (less than one cheeseburger) for 8 weeks has been associated with remission in almost nine out of ten people with recently diagnosed diabetes and in a half of people with longstanding disease.
However, there is little evidence to show whether the same effect can be achieved by people undergoing less intensive interventions, which are more feasible and potentially scalable to the wider population. To answer this question, a team led by researchers at the University of Cambridge studied data from the ADDITION-Cambridge trial, a prospective cohort study of 867 people with newly diagnosed diabetes aged 40 and 69 years recruited from general practices in the eastern region.
The research was funded by Wellcome, the Medical Research Council and the National Institute for Health Research.
The researchers found that 257 participants (30%) participants were in remission at five-year follow-up. People who achieved weight loss of 10% or more within the first five years after diagnosis were more than twice as likely to go into remission compared to people who maintained the same weight.
"We've known for some time now that it's possible to send diabetes into remission using fairly drastic measures such as intensive weight loss programmes and extreme calorie restriction," says Dr Hajira Dambha-Miller from the Department of Public Health and Primary Care.
"These interventions can be very challenging to individuals and difficult to achieve. But, our results suggest that it may be possible to get rid of diabetes, for at least five years, with a more modest weight loss of 10%. This will be more motivating and hence more achievable for many people."
Senior author Professor Simon Griffin of the MRC Epidemiology Unit added: "This reinforces the importance of managing one's weight, which can be achieved through changes in diet and increasing physical activity. Type 2 diabetes, while a chronic disease, can lead to significant complications, but as our study shows, can be controlled and even reversed."
In order to clarify the best way to help patients with type 2 diabetes achieve sustained weight loss, the team is currently undertaking a study called GLoW (Glucose Lowering through Weight management). The study compares the current education programme offered by the NHS to people after they have been diagnosed, with a programme delivered by WW (formerly Weight Watchers®). The team is looking to recruit individuals who have been diagnosed with type 2 diabetes within the last three years, have not attended a structured education programme and are able to visit one of our testing centres in Wisbech, Ely or Addenbrooke's Hospital. Further details can be found at the GLOW Study website.
Dambha-Miller, H et al. Behaviour change, weight loss and remission of type 2 diabetes: a community based prospective cohort study. Diabetic Medicine; DOI: 10.1111/dme.14122