How to achieve remission from type 2 diabetes

The aging of the population, increasing obesity and a sedentary lifestyle contribute to the annual increase in type 2 diabetes worldwide. But a new study shows that remission is possible for many people with lifestyle changes. The findings could help doctors effectively support people who currently have type 2 diabetes or who are at high risk of developing it.

Diabetes is a major global health problem, affecting mortality rates and the quality of life of people with diabetes and their families. Although there are many treatment options to control the disease, many people go beyond managing their disease to achieve remission. A new study using data from Scotland finds that a significant number of people diagnosed with type 2 diabetes are in remission. The researchers also sought to define the factors that promote remission. The results are published in the open-access journal PLOS Medicine.

Diabetes management or remission

In 2019, more than 422 million people worldwide had been diagnosed with diabetes. Experts estimate that by 2045, 700 million people will be affected by this disease. The aging of the population, increasing obesity and a sedentary lifestyle are all contributing to this projected increase. Although many people manage or control their diabetes through glucose-lowering therapy, the general definition of type 2 diabetes remission is achieving normal blood glucose readings without the use of glucose-targeting drugs.

Some people have achieved remission through bariatric surgeries, including gastric bypass and gastric banding. Others have achieved remission after participating in research trials that tested low calorie diets followed by structured weight loss management programs.

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A very recent study suggests that many people achieve remission without surgery. Using the Scottish Care Information Registry (Diabetes Collaboration (SCI-DC), researchers used data from more than 162,000 people aged over 30, diagnosed with type 2 diabetes and alive as of 31 December 2019.

Study results

The study found that 7,710 of the study participants, or about 5%, were in remission from type 2 diabetes. The researchers defined remission as a hemoglobin A1c level below 48 millimoles per mole (mmol /mol) after not using hypoglycemic drugs for more than 365 consecutive days. The A1C test, also known as the hemoglobin A1C or HbA1c test, is a simple blood test that measures your average blood sugar level over the past three months.

The results showed that people who achieved remission tended to be older, never take blood sugar-lowering drugs, have lower blood sugar levels at diagnosis, or have lost weight since diagnosis of the disease. diabetes, whether through diet or bariatric surgery.

The scientists then compared the characteristics of people in remission with those who were not. According to the authors, understanding the number of people in remission and the factors that led to this state is important to identify the groups most likely to achieve remission. It is then necessary to target the limited resources for intensive management of the way of life of these groups. Although bariatric surgery was strongly associated with diabetes remission, the authors are quick to point out that this procedure was rare among study participants.

Identifying people who have put their diabetes into remission outside of research trials is important to ensure they receive the ongoing support they need. These results could also shed light on who in the general population has the best chance of remission. Which would help healthcare professionals start essential conversations with the people most likely to benefit.

Future prevention

In addition to creating a baseline for future initiatives and studies, the insights gained from this study indicate the importance of lifestyle choices and education in the treatment and eventual prevention of disease.

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In this study, the focus is on diet. but there are several other lifestyle modifications, diet programs, and a lot of social awareness, especially through social media. It is a multifaceted phenomenon. And it is very important to detect diabetes early and then provide the necessary support. While these results are certainly encouraging, it is important to recognize that diabetes remission may not be permanent.

It should also be noted that 74% of the participants in this study were white. Therefore, the results may not apply to other groups. There was also no information on why people underwent bariatric surgery, whether to treat obesity or because of stomach cancer, for example.

The Look Action for Health in Diabetes trial took place in the United States in adults with type 2 diabetes who were overweight or obese. Of the participants who had achieved remission, nearly half of the control group reverted to type 2 diabetes within a year, as did a third of the group who received intensive lifestyle intervention. The authors of the new study conclude: “Further research is needed to investigate the association between remission and diabetes complications, including mortality, particularly the effect of different durations of sustained remission. »




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