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Type 2 diabetes is generally considered to be a chronic health condition that can’t be cured once it develops, and can only be managed with a combination of medication and healthy living – assisted by gastric band (bariatric) surgery in some cases.
But new research suggests that people may actually be able to beat the disease for set periods, by undertaking an intensive short-term course of medical treatment that’s been shown to reverse type 2 diabetes in a significant proportion of patients.
“By using a combination of oral medications, insulin, and lifestyle therapies to treat patients intensively for two to four months, we found that up to 40 percent of participants were able to stay in remission three months after stopping diabetes medications,” says one of the researchers, Natalia McInnes from McMaster University in Canada.
“The findings support the notion that type 2 diabetes can be reversed, at least in the short term – not only with bariatric surgery, but with medical approaches.”
Type 2 diabetes is caused by the body not producing enough insulin – the hormone that enables cells to absorb glucose – or becoming insulin resistant. As a consequence, blood sugars build up in the body, and can lead to serious health problems like organ damage and heart disease.
Over 29 million Americans have type 2 diabetes, and estimates indicate that it could cost the US health care system as much as US$512 billion annually by 2021 – so any interventions that can effectively treat the condition are desperately needed.
To investigate whether intensive health treatments could trigger remission in type 2 diabetes patients, the researchers recruited 83 participants with the condition and randomly divided them into three groups.
Two of these groups received the short-term interventions – lasting for eight weeks or 16 weeks respectively – where they were given personalised exercise plans, meal plans that lowered their calorie intake by 500 to 750 calories a day, and regular meetings with a nurse and dietitian.
During the treatment period, they also took insulin and a set course of oral medications to help them manage the condition.
The third group of participants acted as controls, and received standard blood sugar management and health advice during the same period.
Three months after the experiment, 11 out of 27 patients in the 16-week intervention group showed complete or partial diabetes remission, as did six out of 28 individuals in the eight-week group.
Comparatively, only four of the participants in the control group showed signs of remission as a result of receiving standard, non-intensive health advice – and the team thinks this gap is evidence that there’s a lot more we can do to try and fight off, rather than just manage, the disease.
“The research might shift the paradigm of treating diabetes from simply controlling glucose to an approach where we induce remission and then monitor patients for any signs of relapse,” says McInnes.
“The idea of reversing the disease is very appealing to individuals with diabetes. It motivates them to make significant lifestyle changes and to achieve normal glucose levels with the help of medications.”
To be clear, that motivation and sense of purpose has to be kept up in the long term for the health gains – and subsequent diabetes reversal – to actually persist for longer than three months.
A year after the trial, the difference between participants who received the treatment and those that did not had become negligible, indicating that more work is needed to figure out how to make type 2 diabetes remission a permanent proposition.
“If you don’t sustain the lifestyle intervention, then the disease is going to come back,” endocrinologist Philip Kern from University of Kentucky, who wasn’t involved with the study, told HealthDay News.
While the remission did not persist – and the results reported here are based on only a small sample of participants in the trial – the findings are the latest to give scientists hope that type 2 diabetes can be beaten if patients commit to dietary and lifestyle changes.
Last month, a study by researchers from the University of Southern California found that a fasting diet in mice could reverse diabetes and repair the pancreas.
And in Britain, researchers being funded by charity Diabetes UK are currently running a large clinical trial to investigate whether diabetes can be reversed in the long term if people stick to a low calorie diet.
“We’re looking forward to seeing the results in 2018. In the meantime, we encourage people with type 2 diabetes to follow a healthy diet that is low in sugar, saturated fats, and salt,” Diabetes UK spokesperson Emily Burns told Sarah Knapton at the The Telegraph.
“We know that diet, exercise, and medications can help people with Type 2 diabetes to manage their condition. We’re starting to see mounting evidence that putting type 2 diabetes into remission is feasible as well.”
The findings are reported in The Journal of Clinical Endocrinology & Metabolism.