Gastric band Surgery In France Is this the formula for reversing type 2 diabetes? The first-year results of a clinical trial have shown that almost half of people partaking in an intensive weight management program delivered through primary care achieved remission of their type 2 diabetes without medication. A trial has shown that type 2 diabetes is reversible if weight is lost and kept off. The trial, which is called the Diabetes Remission Clinical Trial (DiRECT), builds on earlier work by co-lead investigator Prof. Roy Taylor, director of the Magnetic Resonance Centre at Newcastle University in the United Kingdom. The earlier work showed that a radical change in diet can reverse type 2 diabetes. The results of the trial, recently reported in The Lancet, suggest that remission of type 2 diabetes may be achievable through intensive weight management programs supported by routine primary care. The team’s findings revealed that after 12 months of radical weight management, participants lost an average of 10 kilograms (22 pounds), and that 45.6 percent of them went back to being non-diabetic without medication. ‘Long-term maintenance of weight loss’ focus Prof. Taylor says that significant weight loss reduces the amount of fat in the liver and pancreas so that they can start working normally again. “What we’re seeing from DiRECT,” he remarks, “is that losing weight isn’t just linked to better management of type 2 diabetes: significant weight loss could actually result in lasting remission.” “Our findings suggest that even if you have had type 2 diabetes for 6 years,” adds trial co-leader Prof. Michael Lean, chair of Human Nutrition at the University of Glasgow in the U.K., “putting the disease into remission is feasible.” He says that their approach differs from the conventional way of managing type 2 diabetes in that it focuses “on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimize individual results.” Diabetes is a global health problem Diabetes is a disease in which the body either does not make enough or cannot effectively use insulin, which is a hormone that helps cells to absorb and turn blood sugar into energy. In type 2 diabetes, the body’s cells do not react to insulin as they should, which is known as insulin resistance. The pancreas – an organ that produces insulin – tries to compensate by producing more insulin, but eventually it cannot make enough, and blood sugar levels go up. High blood sugar, or hyperglycemia, damages many parts of the body and can lead to severe health problems, including heart disease, vision impairment, and kidney disease. Of the hundreds of millions of people worldwide who have diabetes, the vast majority have type 2, which results largely from carrying too much weight and not being physically active. In the United States, around 90-95 percent of the 30 million people with diabetes have type 2. And while it normally strikes people aged 45 and older, an increasing number of children and young adults are also developing type 2 diabetes. Intensive weight management vs. usual care The first-year results of DiRECT concern 298 people aged 20-65 years old who were recruited to the trial between July 2014 and August 2016, and who had been diagnosed with type 2 diabetes during the previous 6 years. They were attending 49 primary care or general practice (GP) clinics across Scotland and a region in North East England. The trial randomly assigned the GP clinics to deliver one of two treatment types: either a radical weight management program called Counterweight Plus, or adherence to current best practice guidelines. This resulted in 149 people following the intensive weight management program and a further 149 people following current practice (the controls). During the first 3-5 months, the participants on weight management consumed a total diet replacement formula that gave them no more than 855 calories per day. After that, they
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