Issue: November 2019

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October 07, 2019
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Likelihood of type 2 diabetes remission heightened with earlier modest weight loss

Issue: November 2019
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Type 2 diabetes remission may be more attainable for those who reduce weight by at least 10% in the year after diagnosis compared to those who gain weight or lose no weight, according to findings published in Diabetic Medicine.

Remission of type 2 diabetes is achievable in the longer term with modest weight loss of > 10% early in the disease trajectory. This can be achieved without intensive interventions in free-living populations,” Hajira Dambha-Miller, MRCGP, PhD, FHEA, a clinical lecturer in the academic unit of primary care and population sciences at the University of Southampton in the U.K., and colleagues wrote. “Our findings should inform discussions with people who have newly diagnosed type 2 diabetes as motivation towards remission of the disease without restrictive and sometimes unachievable calorie restrictions.”

Dambha-Miller and colleagues analyzed data from 867 participants from the ADDITION-Cambridge trial. From 2002 to 2006, type 2 diabetes was diagnosed in the cohort, after which researchers randomly assigned participants to a multifactorial diabetes intervention or standard diabetes care. According to the researchers, participants in the intervention received “more frequent consultations” pertaining to diabetes care. The researchers collected information on physical activity, diet and alcohol intake via participant self-report at baseline, 1 year and 5 years when they also measured body weight, blood pressure, HbA1c and lipids.

At 5 years, 257 participants experienced diabetes remission defined as HbA1c below 6.5%, according to the researchers. In fully adjusted models, the likelihood of reaching remission at 1 year was 1.77 times greater for those who lost 10% or more of their baseline body weight compared with those whose weight changed by 2.5% or less (RR = 1.77; 955 CI, 1.32-2.38). At 5 years, compared with those whose weight changed by 2.5% or less at year 1, the likelihood of reaching remission was 1.43 times greater for those who lost at least 5% but less than 10% of their baseline body weight at year 1 (RR = 1.43; 95% CI, 1.03-1.98) and 2.43 times greater for those who lost at least 10% of their baseline bodyweight at year 1 (RR = 2.43; 95% CI, 1.78-3.31).

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Type 2 diabetes remission may be more attainable for those who reduce weight by at least 10% in the year after diagnosis compared to those who gain weight or lose no weight.

The researchers noted that “the greater the amount of weight loss achieved, the higher the likelihood of remission.”

“Our results suggest that more modest weight loss of > 10% is associated with a higher likelihood of remission if this occurs early in the disease trajectory. This may provide some rationale for motivating people with newly diagnosed type 2 diabetes to lose weight rather than focusing on specific and potentially unachievable weight targets,” the researchers wrote. “Our data suggest that, in addition to extending availability of intensive weight-loss interventions, policymakers should consider a range of accessible approaches targeting weight loss amongst people with newly diagnosed diabetes.” – by Phil Neuffer

Disclosures: Dambha-Miller reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.