The number of diabetics increased from 108 million to 422 million from the time period of 1980 to 2014.
The diabetes pandemic has little pharmacological interventions to stop this. Though other approaches failed, lifestyle interventions succeeded in the area.
Medical News Today reported the first results of a clinical trial a couple years back. The result showed the weight loss was the key to achieving remission for type 2 diabetes without consuming any medication.
Prof. Roy Taylor from Newcastle University in the UK, was one of the leaders who conducted this trial. The trial was called Diabetes Remission Clinical Trial (DiRECT).
Prof. Taylor and his team spent a decade to test and confirm the twin cycle hypothesis.
Type 2 diabetes results from the build up of fat in the liver causing insulin resistance and increases blood sugar production according to the theory.
Following up with this, insulin stimulates fat production from plasma insulin levels increasing, causing a self-reinforcing cycle.
The pancreas and several tissues are affected by the overspill of lipids caused from the increased levels of liver fat.
The researchers wanted to “describe the pathophysiologic processes underlying the recurrence of type 2 diabetes in the group that initially achieved remission but then relapsed back to diabetes.”
The researchers quantified intra-organ and abdominal fat using cutting-edge MRI scans for 12-24 months to conclude this. The pancreatic and liver fat was observed specifically.
The analysis included measurements of glucose, HbA1c, high-density lipoprotein (HDL) cholesterol, and triglycerides. The team also analyzed fatty acids, insulin secretion, and beta-cell function.
HbA1c, high-density lipoprotein (HDL) cholesterol, and triglycerides were included as measurements for this analysis along with fatty acids, insulin secretion and beta-cell function.
When liver fat ‘clogs up’ the pancreas
Remission over 2 years if the triglycerides and fat in the pancreas was kept low in the results of the study.
9 out of 10 participants, specifically those who lost 15kg or more in the DiRECT trial managed to reverse their condition.
One-third of these people were freed from diabetes after 2 years as well as being free from diabetes medication for 2 years.
A small group, however, experienced relapse, which was associated with a return to high liver triglycerides and high intrapancreatic fat levels.
Prof. Taylor explains: “We saw that when a person accumulates too much fat, which should be stored under the skin, then it has to go elsewhere in the body. The amount that can be stored under the skin varies from person to person, indicating a ‘personal fat threshold’ above which fat can cause mischief.”
“When fat cannot be safely stored under the skin, it is then stored inside the liver and overspills to the rest of the body, including the pancreas. This ‘clogs up’ the pancreas, switching off the genes that direct how insulin should effectively be produced, and this causes type 2 diabetes.”
Prof. Roy Taylor
‘Diet and persistence’ can reverse diabetes
“This means we can now see type 2 diabetes as a simple condition where the individual has accumulated more fat than they can cope with,” continues the author, stressing the hopeful implications of this finding.
“Importantly, this means that through diet and persistence, patients are able to lose the fat and potentially reverse their diabetes. The sooner this is done after diagnosis, the more likely it is that remission can be achieved.”
“For the first time,” conclude Prof. Taylor and team in their paper, “we are able to report the underlying physiologic changes during a full cycle of disease reversal and re-emergence.”
Programs that test weight loss therapy will be rolled out by the National Health Service (NHS) for thousands with type 2 diabetes in the UK.
1st April 2020 20:10
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