The prevalence of type 2 diabetes has significantly increased over the past few decades, with factors such as obesity and lack of exercise contributing to the rise. Insulin resistance, which leads to elevated blood sugar levels, is a key characteristic of diabetes. Obesity can trigger insulin resistance by releasing certain hormones and immune cells that interfere with insulin’s function. Additionally, obesity can complicate diabetes treatment as some medications may cause weight gain, further exacerbating glucose control. However, weight loss has been shown to induce remission in some individuals with type 2 diabetes.
To address this gap, researchers from the Chinese University of Hong Kong conducted an analysis using data from the Risk Assessment and Management Programme for Diabetes Mellitus (RAMP-DM) in Hong Kong. The study included 37,326 individuals with type 2 diabetes who were enrolled in the program within a year of diagnosis between 2000 and 2017.
The findings revealed that only 6.1% of the participants remained in remission from type 2 diabetes after eight years. Individuals who had lost 10% or more of their total body weight within the first year of diagnosis were over three times more likely to achieve remission compared to those who gained weight. Similarly, those who had lost between 5% and 9.9% of their body weight had more than double the likelihood of remission compared to weight gainers. However, even minimal weight loss of up to 4.9% showed only a slight improvement in remission rates compared to weight gainers.
Moreover, the risk of developing type 2 diabetes again after remission was significantly lower for those who had lost more weight. Individuals who had lost over 10% of their body weight had a 48% lower risk, while those who had lost between 5% and 9.9% had a 22% lower risk. Even those who had lost less than 4.9% of their body weight had a 10% reduced risk compared to weight gainers.
The study clearly demonstrated that early weight loss increased the chances of achieving remission from type 2 diabetes. However, the real-world setting presented challenges in both achieving and maintaining remission. Clinical trials often provide specific dietary interventions without considering the long-term sustainability of these diets. Registered dietician Dan Gallagher emphasized that long-term dietary changes were crucial for managing type 2 diabetes effectively. He noted that a complete lifestyle change, rather than a temporary fix, was necessary to maintain blood sugar control.
Dr. Mir Ali, a bariatric surgeon, highlighted the success of bariatric surgery in achieving weight loss and long-term remission of various medical conditions, including type 2 diabetes. While clinical trials have shown promising results, replicating these outcomes in real-world settings remains challenging. However, with the right approach and commitment to lifestyle changes, managing and potentially reversing type 2 diabetes is attainable.