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Diabetes remission may occur by losing weight, pancreas fat

LOS ANGELES — Adults with type 2 diabetes may achieve sustainable remission if they lost 15 kg of body weight and 0.5 g fat in the pancreas and liver, according to preliminary findings presented at the American Association of Clinical Endocrinologists Annual Scientific and Clinical Congress.

Roy Taylor, MD, professor of medicine and metabolism at Newcastle University in the United Kingdom, told attendees about his “twin cycle hypothesis” — weight loss following a low-calorie diet normalizes the first phase insulin response in the pancreas.

Taylor said his two-pronged theory is partially based on several studies in adults with type 2 diabetes. In the first study, losing weight corresponded to lowering HbA1c levels. In the second, those who underwent bariatric surgery had normalized first phase insulin secretion and a “highly significant change” in pancreas fat vs. patients who did not have type 2 diabetes.

He added that his findings are a long way from becoming clinical practice.

“We haven’t gotten this perfectly right yet,” he said. “There is so much more work to do in understanding how to achieve prevention of weight regain. Certainly, other behavioral interventions, certainly, perhaps, GLP-1 agonists, other agents could be used. All of that is to be explored because this is the start of a story, not the end of it.”

Click here for more Healio coverage of Taylor’s presentation. – by Janel Miller and Phil Neuffer

References:

Taylor, et al. “Type 2 diabetes remission as a therapeutic goal.” Presented at: American Association of Clinical Endocrinologists Annual Scientific and Clinical Congress. April 24-28, 2019; Los Angeles.

Steven S, et al. Diabetes Care. 2016;doi:10.2337/dc15-0750.

Lim EL, et al. Diabetologia. 2011;doi:10.1007/s00125-011-2204-7.

Lean MEJ, et al. Lancet Diabetes Endocrinol. 2019;doi: 10.1016/S2213-8587(19)30068-3.

Taylor R, et al. Diabetologia. 2019;doi:10.1007/s00125-017-4503-0.

Steven S, et al. Diabetes Care. 2016;doi:10.2337/dc15-1942.

Disclosure: Taylor reports that he is a member of the U.K. government’s working group on low carbohydrate diets and then he receives lecture fees from Novartis and Lilly & Janssen and is on the advisory board for Wilmington Healthcare.