Scientists talked about a way to achieve remission of type 2 diabetes

Type 2 diabetes, which develops at a young age, can lead to a faster deterioration in blood sugar control and increase the risk of complications. Therefore, researchers are looking for ways not only to control the disease, but also to achieve its remission. One such approach may be a combination of calorie reduction and regular physical activity. The Izvestia article describes how effective such a program has proved to be for young adults.

Diabetes at a young age

Scientists from Canada and the UK conducted a clinical trial involving 96 people aged 18 to 45 years. All participants had type 2 diabetes, diagnosed no more than six years ago, and obesity. They did not take insulin or weight loss medications. The results of the work are published in The Lancet Regional Health – Americas journal.

The participants were randomly divided into two groups. The former continued to receive routine medical care, while the latter underwent a 24-week program that combined low-calorie nutrition and physical activity under the supervision of specialists. It included 50 people, 46 in the control group.

The researchers estimated how many participants would be able to achieve diabetes remission, and also studied changes in body weight, the amount of fat and muscle tissue, physical fitness, and other health indicators.

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Diet and exercise

For the first 12 weeks, the participants in the experimental group followed a diet with an energy value of 800-900 kcal per day. On training days, they were additionally recommended to consume 200-250 kcal. During the first two weeks, all meals were replaced with special products, and later one regular meal per day was allowed.

From the third week, the participants started exercising under the supervision of physical fitness specialists. Two workouts per week included aerobic and strength exercises and gradually increased to about an hour each. The participants performed another aerobic workout on their own.

Over the next 12 weeks, they gradually switched to nutrition to maintain weight and continued to exercise without constant supervision from specialists. At the beginning of the program, doctors also reviewed taking medications to lower glucose levels and blood pressure. They were canceled in the absence of medical indications, and if necessary, they could be prescribed again. Thus, the program was aimed not only at reducing body weight. The scientists also wanted to test whether physical activity would help preserve muscles and improve physical fitness during intense weight loss.

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54% of participants had remission.

After 24 weeks, 27 of the 50 participants in the program, 54%, achieved diabetes remission. In the control group, two out of 46 people showed this result — about 4%. Remission was determined by the level of glycated hemoglobin below 6.5% in the absence of sugar-lowering drugs for at least 12 weeks.

Participants in the program lost an average of 7.5 kg more than people who received regular medical care. At the same time, the decrease in body weight occurred mainly due to adipose tissue. Its amount decreased by 16.5% relative to the control group, while no significant differences in changes in muscle volume and fat-free mass were found between the groups.

In addition, some of the participants' physical fitness indicators improved. Hand grip strength was 7.6% higher, and physical endurance, including body weight, was 10.3% higher than in the control group. Blood pressure and resting heart rate also decreased. The researchers also noted a decrease in the amount of fat in the liver and pancreas.

Among the 14 participants who lost at least 10% of their initial body weight during the program, all achieved remission. However, this subgroup was small, so the result does not allow us to conclude that such weight loss guarantees remission.

The result needs to be checked

Despite the encouraging figures, the authors pointed out several limitations. There was no single group in the study that followed only a low-calorie diet without exercise. Therefore, scientists were unable to determine how much physical activity by itself increased the likelihood of remission and what contribution it made to maintaining muscle mass and improving physical fitness.

In addition, the follow-up lasted only 24 weeks. It is not yet known how long the participants will be able to maintain their achieved remission and what will happen if their body weight increases again. The study also included a small and carefully selected group of patients, so its results cannot be automatically extended to all people with type 2 diabetes.

Side effects were registered in 43 of the 50 participants in the program and in six people from the control group. Most often it was about constipation, headache, dizziness and fatigue. The researchers did not identify any serious adverse events.

The authors believe that a combination of a low-calorie diet and controlled physical activity may be a promising approach to achieving remission in young adults with type 2 diabetes and obesity. However, larger and longer-term studies are needed to assess the sustainability of the effect and determine the additional benefits of training.