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Insulin-Producing Beta Cells Can Be Restored in Patients with Type 2 Diabetes

According to science presented at the American Diabetes Association’s 79th Scientific Sessions, pancreatic beta cells that are not producing sufficient insulin in patients with type 2 diabetes are not actually permanently destroyed and through the removal of excess fat in the cells, could be restored. 

The study, “Remission of Type 2 Diabetes for Two Years Is Associated with Full Recovery of Beta-Cell Functional Mass in the Diabetes Remission Clinical Trial (DiRECT)” found that 36% of trial participants that committed to an intensive weight management program saw remission of their type 2 diabetes after 2 years. 

The open-labeled, cluster-randomized, controlled trial comprised 306 participants from 49 primary care practices in Scotland and England between 2014 and 2017, ranging in ages from 20  to 65 years old.

“Type 2 diabetes is a progressive disease over time, and previous research has suggested beta cell death is the root cause of increasing failure of insulin-production and severity of T2D,” according to a press release presented at the scientific sessions. 

Researchers used a “Stepped Insulin Secretion Test with Arginine (SISTA) to quantify functional beta cell mass (maximum insulin secretory response during hyperglycemia). Insulin secretion rates were estimated by de-convolution, and participants’[hemoglobin] A1C and fasting plasma glucose levels were assessed.”

From this testing, the researchers found that patients that were capable of achieving remission, were able to remain in remission 2 years after DiRECT’s completion. 

“Our research explains the observed recovery from [type 2 diabetes]. Equally as important, though, is the finding that recovery can be achieved through primary care as part of routine health care following current standards of care,” said co-lead study investigator Roy Taylor, MD, FRCP, FRCPE, professor of medicine and metabolism at Newcastle University and Newcastle Hospitals NHS Trust. “People with type 2 diabetes have a choice rather than a life sentence. If the simple, effective method of weight loss and minimization of weight regain is undertaken, individuals with early type 2 diabetes can return to normal health with a profound decrease in risk of serious long-term complications associated with diabetes such as cardiac disease.”

Dr Taylor continued, “Type 2 diabetes is a reversible condition, and remission can be achieved and sustained. Our research has also discovered a key message surrounding weight loss treatments. The current slow, steady approach is difficult and successful for only a few. In contrast, the approach of rapid, short-term weight loss followed by a long-term phase of avoidance of weight gain has been shown to be more productive.”—Edan Stanley

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