Reversing Type 2 Diabetes is More Challenging Than Clinical Trials Indicate

People with type 2 diabetes who lose weight while participating in clinical trials appear to be significantly more likely to have their symptoms reversed than those who lose weight outside of such studies.

Treatments such as insulin injections can help people with type 2 diabetes maintain healthy blood sugar levels. However, if you are overweight or obese, your symptoms may improve when you lose weight.

In fact, less than 10 percent of people with type 2 diabetes who lose weight outside of these trials actually lose weight, even when followed for several years. Wu Hongjian At the Chinese University of Hong Kong. In exams, this number can be closer to 90%.

These discrepancies may be due to sometimes different definitions of what it means to reverse type 2 diabetes, as well as the support and different interventions that often accompany participation in clinical trials. he says.

To better understand this, Dr. Wu and colleagues looked at more than 37,000 people in Hong Kong aged 18 to 75 who were diagnosed with type 2 diabetes between 2000 and 2017, about half of whom were women. ) was studied.

Each participant was followed for an average of just under eight years, and the researchers looked at how their weight changed in the year after diagnosis and whether their symptoms improved during the study period.

The researchers measured glycated hemoglobin (HbA1c) levels, which reflect the participants’ blood sugar status over several months. To reverse type 2 diabetes, also called remission, Generally defined as an HbA1c of less than 6.5 percent. When measured at least 3 months after stopping treatment. The researchers were investigating whether these levels occurred during her two consecutive tests conducted six months apart.

The research team only measured the participants’ weight one year after diagnosis, at which point 2% were in remission and half had gained weight, Wu said.

By the end of the study, 6% were in remission at some point, Wu said. About two-thirds of these people needed diabetes medication to get their symptoms back under control within three years.

However, by simply recording participants’ weight one year after diagnosis, the researchers were not able to determine whether the participants continued to gain weight or whether other factors, such as gaining weight at a particular time, could account for some of the weight. We do not know whether it brought participants out of remission. Fat that accumulates around the waist and certain internal organs.

In contrast, one small clinical trial found that up to 86% of type 2 diabetics who lost at least 15 kg went into remission within 1 year. People participating in such studies often benefit from professional dietary management, physical exercise programs, moral support, regular monitoring, feedback, reminders and encouragement, Wu says.

But even people who participate in the control groups of some clinical trials and don’t undergo intensive weight loss programs have higher remission rates than what was seen in Wu’s team’s study.

That may be because, outside of clinical trials, doctors are often reluctant to advise patients with type 2 diabetes to stop treatment, he says. This likely also has to do with differences in how remission is defined, Wu said, since trials often require only one HbA1c measurement in a healthy patient.