admin Globally, the incidence of diabetes continues to increase and thus the fight against this chronic condition continues. But, according to new research, it is possible to know what triggers type 2 diabetes as well as how to reverse the condition. The findings also focus on what leads to remission after reversal for some people.
Across the world from last few decades, people living with diabetes increased from about 108 million to 422 million and approximately 90% of these individuals have type 2 diabetes.
A couple of years ago, the first results of a clinical trial, which showed that intensive weight loss programs could help people with type 2 diabetes achieve remission without taking any medication, which was called the Diabetes Remission Clinical Trial (DiRECT), and one of its co-leaders was from Newcastle University in the United Kingdom, Prof. Roy Taylor.
Prof. Taylor set out with his team to answer how this remission occurs, using data from the DiRECT trial and applying cutting-edge imaging and blood monitoring techniques. Their findings published in the journal Cell Metabolism.
The study, which Prof. Taylor and team put forth more than a decade ago, aimed to test and confirm the so-called twin cycle hypothesis, and proposed that type 2 diabetes results from the accumulation of fat in the liver inducing insulin resistance and increasing blood sugar production.
And, these effects increase plasma insulin levels, precipitating “a self-reinforcing cycle” in which insulin stimulates fat production and these increased levels of liver fat cause the lipids to overspill into several tissues, including the pancreas.
In the present study, the authors investigated the predictions of the twin cycle hypothesis 2 years into the DiRECT trial.
The researchers wanted to “describe the pathophysiologic processes underlying the recurrence of type 2 diabetes in the group that initially achieved remission but then relapsed back to diabetes.”
To this end, the researchers quantified intra-organ and abdominal fat using cutting-edge MRI scans at 12 and 24 months. They looked at pancreatic and liver fat, specifically.
The analysis included measurements of glucose, HbA1c, high-density lipoprotein (HDL) cholesterol, and triglycerides. The team also analyzed fatty acids, insulin secretion, and beta-cell function.
The study revealed that the majority of the trial participants maintained remission over the 2 years but that this was only possible if liver triglycerides and fat in the pancreas remained low.
Specifically, almost 9 out of 10 participants who managed to lose 15 kilograms or more in the DiRECT trial reversed their condition.
After 2 years, more than one-third of these individuals had been free of diabetes and the need for diabetes medication for at least 24 months.
Source: medicalnewstoday
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