- Beta cells that lose function do not always stay permanently damaged in type 2 diabetes (T2D).
- In the DiRECT trial, participants followed a weight-loss program intended to produce yields comparable to bariatric surgery, and more than a third had T2D remission after 2 years.
Why this matters
- The authors said in a statement that the findings indicate the possibility of using primary care tools to achieve T2D remission.
- Findings vary from RISE (Restoring Insulin Secretion) Adult Medication Study, showing no persistence in beta-cell improvement following treatment withdrawal.
- 40 people achieved remission; 20 stayed so at 2 years, 13 gained weight and had a relapse, and 7 were lost to follow-up.
- Insulin secretion in the group almost doubled over the 2-year period, from 0.58 nmol/minute/m2 (95% CI, 0.48-0.81) to 0.94 nmol/minute/m2 (95% CI, 0.64-1.44).
- Those who had remission did not, however, reach normal HbA1c, fasting blood glucose values.
- Better outcomes seen with more weight loss.
- The intervention involved a weight-management program with withdrawal from antihypertensives and antihyperglycemic drugs, diet replacement with 825-853 kcal/day for 3-5 months, and carefully structured food introduction and support for weight-loss maintenance.
- Conference presentation of non-peer-reviewed findings in a small study population.