The 2 year follow up results have been published for the type 2 diabetes remission study.
However, for those of you who like to cut to the chase here’s the basics. In late 2017 Diabetes UK, the University of Glasgow and the University of Newcastle collaborated to see if they could help people put their type 2 diabetes into remission.
Most type 2 diabetes is caused by fat accumulating in the body, specifically around the pancreas and liver, and so losing this weight could push it into remission. This is what they set out to study.
My medical colleagues inform me historically type 2 diabetes was taught as a progressive disease. In other words, once you had it, expect it to get worse. This surprised me actually as there is data stretching back to the 70’s which indicates otherwise but these weren’t large studies.
Only newly diagnosed (within 6 years) and overweight patients were recruited to the study. These patients also had to had to be receiving some form of diabetes medication.
They recruited about 300 people and split them into 2 groups. One group received 800kcal via milkshakes everyday for 3-5 months. This was followed by a maintenance diet using a more balanced approach. The other group received no intervention.
By the end of the first year 46% (out of 150) of patients had put their type 2 diabetes into remission. A good proportion of patients who didn’t manage remission still managed to reduce their medication burden and so the results were certainly promising.
The patients who lost the most weight were more likely to achieve remission. Patients who were more newly diagnosed also had a better chance of achieving remission.
We are now getting the data for the second year. 36% of people who received the diet remained in remission. This means 70% of people who achieved remission were still in remission at year 2.
This is an interesting finding because it implies remission can be sustained, in the short term anyway. Studies published historically have typically shown patients relapse by year 5 and therefore it will be interesting to see how this study progresses over time.
Regardless of anything, achieving remission is a good thing. For starters, it gives patients hope they can improve their condition. Secondly, pushing it into remission as opposed to running high glucose levels is obviously better for your health. At present though, the big unknown factor is how this effects long term outcomes for patients. Presumably if they keep it in remission and control it well, the long term outcomes will be favourable. However, if they achieve remission for a certain period but ultimately end up with high glucose levels or multiple medication, does this period of remission improve health long term?
I guess we will just have to wait and see. This study isn’t the largest study but it is well designed. I’ve never been one to endorse drastic diets like 800kcal/day but here I think it may have a place. The diet is nutritionally complete so it gives you everything you need. From patient feedback they prefer to see some results as it pushes them on to keep going. It is also for the short term so if it works why not do it. However, it’s not for everyone and it is blooming hard to follow.
It’s worth pointing out the same results could be achieved via more conventional weight loss methods i.e. lifestyle change. This is in fact my preferred method. There is nothing magical about 800kcal. It is purely to do with the weight loss which addresses the underlying cause of the diabetes. The problem is most of these patients have struggled with their weight and conventional methods have often not worked for them.
If you have more questions on the this please feel free to drop me an email.