An intensive combination of oral medications, insulin and lifestyle therapies for two to four months helps diabetics to stay away from medicines for 3 months.
Highlights
- Individuals with type 2 diabetes often need to use a healthy diet, exercise and an increasingly complex combination of medications to manage the condition.
- Type 2 diabetes can be reversed, at least in the short term--not only with bariatric surgery, but with medical approaches.
Though it can’t be completely cured, it can be managed. But now, a recent study claims to reverse the condition.
"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," said the study's first author, Natalia McInnes. "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."
Testing Relapse of Diabetes After Intervention
Eighty three subjects with type 2 diabetes were randomized in three groups. Two of the groups received an intensive metabolic intervention where they were provided with a personalized exercise plan and a suggested meal plan that reduced their daily calorie intake by 500 to 750 calories a day.
The two intervention groups were compared to a control group of individuals with type 2 diabetes. Participants in this group received standard blood sugar management advice from their usual healthcare provider for the duration of the trial, and they received standard lifestyle advice. Participants in all three groups received usual diabetes care if they experienced a diabetes relapse.
Reversing Diabetes
Three months after the intervention was completed, 11 out of 27 individuals in the 16-week intervention group met HbA1C criteria for complete or partial diabetes remission, compared to four out of 28 individuals in the control group. Three months after finishing the eight-week intervention, six out of 28 individuals in that group met the same criteria for complete or partial diabetes remission.
"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," McInnes said.
"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. This likely gives pancreas a rest and decreases fat stores in the body, which in turn improves insulin production and effectiveness."
The senior investigator on the trial, Hertzel C. Gerstein, MD, MSc, FRCPC, of McMaster University and Hamilton Health Sciences added, "We chose to use metformin, acarbose and basal insulin glargine in this trial as these medications have all been shown to slow or prevent the development of type 2 diabetes. However, other drug combinations could lead to higher remission rates and need to be systematically studied with regard to this outcome."
Reference
- Natalia McInnes et al., Piloting a Remission Strategy in Type 2 Diabetes: Results of a Randomized Controlled Trial, J Clin Endocrinol Metabology (2017) https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2016-3373.
Source-Medindia