Can losing weight get rid of diabetes?
“Our findings suggest that even if you have had type 2 diabetes for 6 years, putting the disease into remission is feasible,” stated lead investigator Michael Lean, MD, of the University of Glasgow. “In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimize individual results.”
Can losing weight get rid of diabetes?
New research1 from scientists in the United Kingdom suggests that remission of type 2 diabetes is possible through weight management.
The trial, led by Michael Lean, MD, of the University of Glasgow, included 306 overweight and obese people, ages 20 to 65, who had type 2 diabetes for a maximum of 6 years.
Half of the participants were randomly assigned to an intervention group that put them on a very low-calorie diet. The other half, the control group, received standard diabetes care but no specific guidelines to cut calories dramatically.
22 pounds lost
After one year, the intervention group lost an average 22 pounds. The control group shed just 2 pounds.
Type 2 diabetes in remission
And after one year, 46% of those in the intervention group were able to achieve remission of type 2 diabetes. Only 4% in the control group did.
Remission was defined as achieving an HbA1c (a measure of long-term blood sugar control) that was less than 6.5% without the use of medication for a minimum of 2 months.
Among those in the low-calorie intervention group, nearly a quarter shed 33 pounds or more, which was the study’s primary goal. None in the control group achieved such a weight loss.
More weight loss, more diabetes remission
The scientists found that the more weight lost, the greater the likelihood of diabetes remission:
Among those who gained weight: 0% achieved remission of diabetes
- For those who lost 0 to 11 pounds: 7% achieved remission
- For those who lost 11 to 22 pounds: 34% achieved remission
- For those who lost 22 to 33 pounds: 57% achieved remission
- For those who lost more than 33 pounds: 86% achieved remission
The need for long-term weight loss
“Our findings suggest that even if you have had type 2 diabetes for 6 years, putting the disease into remission is feasible,” stated Dr. Lean in a Lancet news release. “In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimize individual results.”
“Impressive”
In an accompanying editorial2 in the same issue of The Lancet, Matti Uusitupa, MD, PhD, of the University of Eastern Finland described the trial’s findings as “impressive.” They “strongly support the view that type 2 diabetes is tightly associated with excessive fat mass in the body.”
This study, he continued, indicates that weight loss should be the top priority in type 2 diabetes treatment. A lifestyle-based, non-pharmacological approach should be revived, he wrote, because “antidiabetic drugs seldom result in normalization of glucose metabolism if patients’ lifestyles remain unchanged.”
Weight regain
It’s vital to keep the weight off.
“If you regain the excess weight, the diabetes will eventually return,” cautions Danine Fruge, MD, Medical Director of the Pritikin Longevity Center in Miami. Pritikin has been teaching healthy-living skills for the prevention and control of diabetes, high blood pressure, and heart disease since 1975.
“What’s driving the return of diabetes isn’t diabetes, per se. It’s something called insulin resistance.”
To better understand what’s going on in our bodies, let’s backtrack a bit with definitions of diabetes and insulin resistance…
What is diabetes?
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is made, stored, and released by cells in the pancreas called beta cells.
When our insulin is malfunctioning, sugar (also called glucose) builds up in the blood.
- A fasting glucose below 100 mg/dL is considered normal.
- A fasting glucose between 100 and 125 mg/dL signals prediabetes.
- A fasting glucose 126 mg/dL or higher means you have diabetes.
Sources
- 1 The Lancet, published online December 5, 2017. DOI: http://dx.doi.org/10.1016/S0140-6736(17)33102-1.
- 2 The Lancet, published online December 5, 2017. DOI: http://dx.doi.org/10.1016/S0140-6736(17)33100-8.
- 3 Diabetes Care, 1994; 17: 1469.
- 4 Journal of Applied Physiology, 2005; 98 (1): 3.