Losing weight can reverse type 2 diabetes, but is rarely achieved or recorded

September 13, 2017
Blood glucose monitoring. Credit: Wikipedia

Type 2 diabetes is generally perceived as progressive and incurable, but for many patients it can be reversed with sustained weight loss of around 15 kg, say experts in The BMJ today.

Louise McCombie at the University of Glasgow and colleagues say and doctors may not realise that type 2 can be reversed, and they call for greater awareness, documentation, and surveillance of remissions to improve and reduce healthcare costs.

Type 2 diabetes now affects about 3.2 million people in the UK. The NHS currently spends almost £1bn (€1bn; $1.3bn) a year (£22m a day) on antidiabetes drugs, and costs are rising worldwide as diabetes rates and drug prices escalate.

Current guidelines advise reducing and cardiovascular risks, primarily with drugs and general lifestyle advice. But many patients still develop complications and remains up to six years shorter than in people without diabetes, say the authors.

The diagnosis also carries important social and financial penalties for individuals, as well as poor health prospects.

In contrast, consistent evidence shows that is associated with extended life expectancy for people with diabetes, and that weight loss of around 15 kg often produces total of type 2 diabetes, they write.

Achieving remission not only has health benefits, it produces a strong sense of personal achievement and empowerment, removes stigma, and may even reduce insurance premiums.

Yet remission is rarely recorded, argue the authors. For example, a US study found remissions in only 0.14% of 120,000 patients followed for seven years, while the Scottish Care Information Diabetes database, which includes every patient in Scotland, shows that less than 0.1% of those with type 2 diabetes were coded as being in remission.

They suggest that lack of agreed criteria and guidance over recoding may have led to hesitation in coding remission, but the main reason for the low recording is probably that few patients are attempting or achieving remission.

"It is in everybody's interest to reclassify people with type 2 diabetes when they become non-diabetic," say the authors. "Official guidelines and international consensus for recording diabetes in remission are needed."

And they conclude: "Appropriate coding will make it possible to monitor progress in achieving remission of type 2 diabetes nationally and internationally and to improve predictions of long term health outcomes for patients with a known duration of remission."

Explore further: Bariatric surgery beats medical control for diabetes remission

More information: Beating type 2 diabetes into remission, The BMJ, www.bmj.com/content/358/bmj.j4030

Related Stories

Bariatric surgery beats medical control for diabetes remission

December 7, 2015
(HealthDay)—Surgery is more effective than medical control for diabetes remission, with predictors including lower baseline glycemia and shorter diabetes duration, according to research published online Dec. 1 in Diabetes ...

Even short-term T2DM remission reduces risk of microvascular Dz

June 14, 2016
(HealthDay)—For patients with type 2 diabetes, remission after bariatric surgery is associated with a reduced risk of microvascular disease, even after subsequent relapse, according to a study published online June 6 in ...

Clinical score may help predict likelihood of bariatric surgery curing type 2 diabetes in patients

April 20, 2016
In a study published online by JAMA Surgery, Annemarie G. Hirsch, Ph.D., M.P.H., of the Geisinger Health System, Danville, Pa., and colleagues examined whether the DiaRem score, a validated score generated from data readily ...

Long-term follow-up after bariatric surgery shows greater rate of diabetes remission

June 10, 2014
In a study that included long-term follow-up of obese patients with type 2 diabetes, bariatric surgery was associated with more frequent diabetes remission and fewer complications than patients who received usual care, according ...

Study duration affects rate of diabetes remission post-RYGB

October 29, 2016
(HealthDay)—After Roux-en-Y gastric bypass (RYGB) surgery, variations in rates of diabetes remission are primarily related to differences in the definition of remission and study duration, according to a review published ...

Fatty acid remodeling seen in T2DM remission post bariatric sx

August 28, 2017
(HealthDay)—Remission of type 2 diabetes (T2D) following biliopancreatic diversion with duodenal switch (DS) is associated with increased disposal of triglycerides (TG) and acylcarnitine production during lipid overload, ...

Recommended for you

Scientists reverse diabetes in a mouse model using modified blood stem cells

November 15, 2017
Researchers at Boston Children's Hospital have successfully reversed type 1 diabetes in a mouse model by infusing blood stem cells pre-treated to produce more of a protein called PD-L1, which is deficient in mice (and people) ...

Pregnancy-related conditions taken together leave moms—and dads—at risk

November 14, 2017
Research has already shown that women who develop either diabetes or high blood pressure during pregnancy are at risk of getting type 2 diabetes, high blood pressure or heart disease years later. Now, a new study from a team ...

Study reveals how a very low calorie diet can reverse type 2 diabetes

November 9, 2017
In a new study, a Yale-led research team uncovers how a very low calorie diet can rapidly reverse type 2 diabetes in animal models. If confirmed in people, the insight provides potential new drug targets for treating this ...

Targeting a microRNA shows potential to enhance effectiveness of diabetes drugs

November 7, 2017
Over the past 15 years, University of Alabama at Birmingham endocrinologist Anath Shalev, M.D., has unraveled a crucial biological pathway that malfunctions in diabetes.

Researchers link Western diet to vascular damage and prediabetes

October 31, 2017
Could short-term exposure to the average American diet increase one's risk for developing diabetes and cardiovascular disease? According to a recent study funded by the American Heart Association (AHA), researchers from New ...

Researchers design synthetic beta cells to secrete insulin in response to high blood sugar

October 30, 2017
Treating type 1 diabetes and some cases of type 2 diabetes has long required painful and frequent insulin injections or a mechanical insulin pump for insulin infusion. But researchers from the University of North Carolina ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.