More than a third of people with type 2 diabetes who took part in a weight management programme delivered in GP practices are in remission two years later.
The latest findings come from the Diabetes UK-funded Diabetes Remission Clinical Trial (DiRECT) and are published in The Lancet Diabetes & Endocrinology.
The new results build on the first year findings, announced in December 2017, which showed that 46% of participants were in remission after twelve months. A year later, 70% of those participants are still in remission.
Remission is closely linked to weight loss, 64% of participants who lost more than 10 kilos were in remission at two years. Participants regained some weight, as expected, between the first and second years of the trial. However, those who were in remission after one year, and who had stayed in remission, had lost a greater amount of weight on average (15.5 kilos) than those who didn’t stay in remission (12 kilos).
As well as resulting in remission for some people, there appear to be additional benefits to taking part in a weight management programme overall. These include a reported better quality of life, improved blood glucose levels and a reduced need for diabetes medications.
Understanding why significant weight loss results in remission of Type 2 diabetes is at the heart of DiRECT. Studies have so far revealed that weight loss reduces the levels of fat inside the liver and pancreas, which in turn leads to the pancreas ‘rebooting’ insulin production again.
Professor Roy Taylor, Director of Newcastle University’s Magnetic Resonance Centre, and co-primary investigator of the DiRECT trial said: "These results are a significant development, and we now understand the biological nature of this reversible condition. However, everyone in remission needs to know that evidence to date tells us that your Type 2 diabetes will return if you regain weight."
Professor Mike Lean, Head of Human Nutrition at Glasgow University, diabetes specialist physician at Glasgow Royal Infirmary, and co-primary investigator of DiRECT, said: “Proving in DiRECT that Type 2 diabetes can be put into remission for two years in over two thirds of people, if they can lose over 10 kilos, is incredibly exciting. Achieving that entirely in NHS primary care is vital.
“People with Type 2 diabetes and healthcare professionals have told us their top research priority is ‘can the condition be reversed or cured’. We can now say, with respect to reversal, that yes it can. Now we must focus on helping people maintain their weight loss and stay in remission for life.”