- Type 2 diabetes (T2D) remission achieved through a low-calorie, weight management program may restore the morphology of abnormal pancreas.
Why this matters
- Although patients with T2D have abnormalities in volume and shape of the pancreas, it is not clearly known if the changes are the consequence or the cause of the condition.
- Analysis of 64 patients with T2D from the DiRECT trial and 64 non-diabetic control individuals matched for age, weight, and sex.
- Individuals with T2D were considered responders if they achieved an HbA1c
- Funding: Diabetes UK.
- Patients with T2D had a significantly smaller pancreatic volume at baseline compared with non-diabetic control individuals (average, 63.8 cm3 vs 79.8 cm3; P<.0001>
- Regardless of the remission status, there was no variation in pancreatic volume between baseline and 5 months after weight loss.
- However, at 24 months, the volume of the pancreas increased by 12.6 cm3 in responders vs 4.5 cm3 in non-responders (P<.0001>
- Patients with T2D had significantly more irregular pancreatic borders compared with non-diabetic individuals (P<.0001>
- However, at 24 months, the borders had normalized in responders, the difference with non-diabetic individuals being non-significant (P=.92).
- Over the study duration, responders lost significantly more intra-pancreatic fat than non-responders (1.56% vs 0.51% reduction; P<.05>
- At 5 months after the initial weight loss, there was a significant increase in first-phase insulin secretion from baseline only in responders (to 0.11 nmol/mL/minute; P<.0001 and was maintained at months.>
- Small sample size.
Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: "These new findings help to build a clearer picture of the biology behind remission, and how the health of the pancreas can be restored by weight loss."