Type 2 diabetes can be reversed with intensive medical treatment using oral medications, insulin and lifestyle therapies, according to a study published in The Journal of Clinical Endocrinology & Metabolism.
Researchers led by Hertzel C. Gerstein, MD, MSc, FRCPC, of McMaster University and Hamilton Health Sciences in Hamilton, Ontario, Canada randomly divided 83 individuals with the type 2 diabetes into three study groups. One group received standard diabetes care, while the other two groups received an intensive metabolic intervention where they were provided with a personalized exercise plan and a suggested meal plan that reduced their daily calorie intake by 500 to 750 calories a day. These study participants met regularly with a nurse and dietitian to track their progress and received oral medications and insulin at bedtime to tightly manage their blood glucose levels. One group underwent the intervention for eight weeks, while the other was treated intensively for 16 weeks. After the intervention, individuals in both groups stopped taking diabetes medications and were encouraged to continue with lifestyle changes. Participants in all three groups received usual diabetes care if they experienced a diabetes relapse.
Study participants had their average blood glucose levels from the past two to three months measured at eight, 20, 28 and 52 weeks to gauge how well their blood sugar was controlled. They also undertook oral glucose tolerance tests.
Three months after the intervention was completed, 11 out of 27 individuals in the 16-week intervention group met HbA1C criteria for complete or partial diabetes remission, compared to four out of 28 individuals in the control group. Three months after finishing the eight-week intervention, six out of 28 individuals in that group met the same criteria for complete or partial diabetes remission.
The authors conclude: “A short course of intensive lifestyle and drug therapy achieves on-treatment normoglycemia and promotes sustained weight loss. It may also achieve prolonged, drug-free diabetes remission and strongly supports ongoing studies of novel medical regimens targeting remission.” They go on to write that despite the study’s limitations (short follow-up, standard diabetes care for patients after the trial), “this trial clearly shows that a multifaceted intensive metabolic strategy that targets normoglycemia and weight loss using pharmacological and lifestyle approaches may achieve remission, is acceptable to patients, and may be easily translated into clinical practice.”
“By using a combination of oral medications, insulin and lifestyle therapies to treat patients intensively for two to four months, we found that up to 40 percent of participants were able to stay in remission three months after stopping diabetes medications,” says the study’s first author, Natalia McInnes, MD, MSc, FRCPC, of McMaster University and Hamilton Health Sciences. “The findings support the notion that type 2 diabetes can be reversed, at least in the short term—not only with bariatric surgery, but with medical approaches.”