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Weight Loss Can Reverse Type 2 Diabetes in Some People, Study Suggests

Researchers have discovered that losing weight reduces fat in the liver and pancreas, making blood sugar go back to normal levels for some.

For a set of people living with type 2 diabetes, losing weight can be the solution for controlling the disease and lowering the risk of developing other health problems.

A number of studies from Newcastle University in Newcastle upon Tyne, United Kingdom, starting in 2011 have favoured this notion, including a new report published online August 2 in the journal Cell Metabolism. This recent investigation examined reasons why substantial weight loss in some patients produces type 2 diabetes remission, which is a state in which most or all signs and symptoms of diabetes disappear.

“Type 2 diabetes has long been regarded as a condition remains a lifetime and steadily grows,” says the study’s lead author, Roy Taylor, MD, the director of the Newcastle Magnetic Resonance Centre. “This study shows exactly how type 2 diabetes may be put into reverse.”

Employing the use of detailed metabolic tests and specially developed MRI scans, Dr. Taylor and his colleagues observed that fat levels in the blood, pancreas, and liver were abnormally high in people with type 2 diabetes. But after following an intensive weight loss program, all participants were able to lower these fat levels.

As the fats reduced inside the liver and the pancreas, some individuals also experienced improved functioning of their pancreatic beta cells, which holds and release insulin, a hormone that helps control blood sugar levels. The likelihood of regaining normal glucose control depends on the ability of the beta cells to recover, the study authors say.

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“Elimination of fat from the pancreas was followed by insulin-producing cells returning to normal only in those people who became diabetes-free,” says Taylor.

Based on a Prior Study Regarding Weight Loss for Reversing Diabetes

This recent study from the scientists at Newcastle University built on results published in December 2017 in the medical journal The Lancet concerning the effects of weight loss on diabetes.

In that investigation, about 46 percent of 149 persons with type 2 diabetes who adhered to a weight loss program achieved remission, which the study defined as a hemoglobin A1C of less than 6.5 percent after one year.

To lose weight, the participants in the intervention group consumed about 825 calories per day in liquid form for three to five months, then modified their diets to less extreme regimens intended to minimize weight gain.

For these individuals, results improved according to the number of pounds shed — 86 percent of those who lost more than 33 pounds attained remission, while 57 percent of those who lost 22 to 33 pounds reached that goal.

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Losing Weight Sooner Beats Later in Diabetes Reversal

Still, while many responded to the weight loss program and achieved remission, some others did not. To further understand why, researchers focused on 29 responders who achieved remission after dieting and 16 nonresponders who dieted but continued to have diabetes.

Taylor and his colleagues observed that people who were unable to restart normal insulin production had lived with diabetes for a longer time. Persons who had lived with diabetes for an average of 3.8 years could not correct their condition through weight loss, while those who had it for an average of 2.7 years were able to regain normal blood sugar control.

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“Type 2 diabetes is likely a reversible condition, but commencing successful major weight loss should be started as early as possible,” says Taylor. “Returning to full health is possible especially after only a few years of type 2 diabetes.”

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Joseph S. Galati, MD, a hepatologist with Liver Specialists of Texas in Houston, recommends weight loss as a means for diabetes control for his patients, and says that this study only underscores the importance of maintaining a healthy weight. Dr. Galati wasn’t involved in the current research.

“In the abode of fatty liver disease, which is highly associated with either prediabetes or fully diagnosed type 2 diabetes, we do know that decreased fat and decreased weight are associated with far better glucose control,” says Galati, who is the author of Eating Yourself Sick: How to Stop Obesity, Fatty Liver, and Diabetes From Killing You and Your Family. “This research reinforces the idea that patients with type 2 diabetes who are obese — which is the vast majority — can improve their blood sugar control as well as their long-term outlook with weight loss.”

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To shed pounds, Galati emphasizes using portion control, avoiding processed foods, and eating fresh vegetables, fruits, and fresh lean meat, poultry, and fish. Regular exercise should also be part of the program. Typically, he talks to patients about first targeting a weight loss goal of 10 percent. Once that is achieved, they typically strive for increments of 5 percent to 7 percent on a 6- to 12-month basis.

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“Everyone has to remember that this is a marathon, not a sprint,” he says. “With weight loss, you need to be patient and methodical.”

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