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Why weight loss produces remission of type 2 diabetes

Why weight loss produces remission of type 2 diabetes

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Dayo Ojerinde

A new study carried out in the University of Newcastle, United Kingdom, has shown that successful response to weight loss was associated with the early and sustained improvement in the functioning of pancreatic beta cells.

The study published in the Journal Cell Metabolism challenges the previous paradigm that beta-cell function is irreversibly lost in patients with type 2 diabetes.

A senior study author, Mr Roy Taylor of the Newcastle University said, “This observation, carries potentially important implications for the initial clinical approach to management.

“At present, the early management of type 2 diabetes tends to involve a period of adjusting to the diagnosis plus pharmacotherapy with lifestyle changes, which in practice are modest. Our data suggest that substantial weight loss at the time of diagnosis was appropriate to rescue the beta cells,” he noted.

The World Health Organization reported that diabetes affects approximately 422 million people worldwide and approximately 90 per cent of cases were type 2 diabetes.

According to, this traditional view was recently challenged by results from the United-Kingdom-based Diabetes Remission Clinical Trial overseen by Taylor and his colleagues.

The study participants, who were diagnosed with type 2 diabetes within six years of the start of the study, were randomly assigned to best-practice care or an intensive primary-care-led weight-management program.

One year later, 46 per cent of the individuals in the intervention group successfully responded to weight loss in that they recovered and maintained control over blood glucose concentrations. Some non-responders simply had not lost enough weight, but in those who had, it was not clear how their response differed from that of responders.

Taylor and his partners, while addressing this question, examined potentially relevant metabolic factors, such as liver fat content, pancreatic fat content, blood concentrations of fats called triglycerides, and beta-cell function.

They found that responders to the weight loss programme were similar to non-responders before the intervention but had a shorter duration of diabetes. Both responders and non-responders had lost comparable amounts of weight, leading to similar reductions in liver fat content, pancreatic fat content, and blood concentrations of triglycerides.

The findings by the researchers suggest that weight loss normalises fat metabolism in all individuals with type 2 diabetes, but the more rapid loss of the capacity of beta cells to recover prevents some individuals from returning to a non-diabetic state.

Taylor also noted that the knowledge of reversibility of type 2 diabetes ultimately due to re-differentiation of pancreatic beta cells will lead to further targeted work to improve understanding of this process.

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