Fresh evidence that weight loss could be the key to putting Type 2 diabetes into remission has been unearthed by a study led by a North East expert.
It is the latest finding of a landmark trial backed funded by Diabetes UK which says the research could “transform the lives of millions of people”.
Headed by Prof Roy Taylor of Newcastle University and Prof Mike Lean of the University of Glasgow, it suggests that for remission to be possible, insulin-producing beta cells in the pancreas need to recover and make the right amount of insulin again.
In their latest study, published in Cell Metabolism, researchers explored exactly how weight loss can put Type 2 diabetes into remission, and why it might work for some people and not others.
Prof Taylor said: “These results provide a dramatic window into the body, allowing us to see exactly what is happening as people change from having Type 2 diabetes to being healthy.”
However they warn the work is still ongoing and anyone with the condition who is considering a low calorie diet should speak to their diabetes healthcare professional first.
The work was part of the Diabetes Remission Clinical Trial (DiRECT).
They measured levels of fat in the liver and pancreas, alongside other metabolic tests, in a subset of people taking part in DiRECT.
They looked for differences between 29 ‘responders’ (people in remission) and 16 ‘non-responders’ (people not in remission) over 12 months.
Researchers found that the greatest difference between two groups lay within their insulin-producing beta cells.
After losing weight, the beta cells of people in remission started to work properly again, releasing the right amount of insulin the body needs.
Their insulin production continued to improve over the course of the study. There was no change in the amount of insulin being made by non-responders – their beta cells had not survived the stress of being surrounded by too much fat.
‘Responders’ had also lived with Type 2 diabetes for slightly less time, compared to ‘non-responders’ (an average of 2.7 years compared to 3.8 years).
Both groups lost a similar amount of weight – 16.2 kg for responders compared to 13.4 kg for non-responders – which was linked to a similar reduction and normalising of fat levels in their liver and pancreas.
These findings add evidence to the theory that shedding liver and pancreas fat is a vital component of putting Type 2 diabetes into remission.
Previous Diabetes UK supported research has shown that beta cells in Type 2 diabetes temporarily lose their ability to function normally. But can recover if stress from high levels of internal fat is removed.
Crucially, results from this latest study suggest that remission is then only possible if beta cells have the capacity to be ‘rebooted’.
Researchers don’t yet know why beta cells are more likely to recover in some people than others, or how to identify those most likely to go into remission.
DiRECT involves 298 people and aims to test if a new weight management approach can put Type 2 diabetes into remission for the long term.
The programme involves a low-calorie diet, reintroduction of healthy food, and long-term support to maintain weight loss.
Initial findings in December 2017 revealed that almost half the participants (46%) receiving the programme were in remission after 12 months and not taking medication for diabetes.
Diabetes UK has committed over £2.8 million to the ongoing trial.
Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: “DiRECT has already provided evidence to suggest that some people can put their Type 2 diabetes into remission, but we didn’t yet know why. This latest study builds on these promising findings and helps us understand how weight loss can help some people to kick-start their insulin production again.
“DiRECT has the potential to transform the lives of millions of people and we’re looking forward to the second-year results as the trial continues.
“But we’re still waiting for all of the evidence, so it’s very important that anyone with Type 2 diabetes considering a low-calorie diet speaks to their diabetes healthcare professional first.”
Source : Chroniclelive