Celeda, CC BY-SA 4.0; 2020 archive crop, illustrative.
More than half of the younger adults in a medically supervised diet and exercise program brought their type 2 diabetes into remission after about six months, according to a small trial published October 1 in The Lancet Regional Health – Americas. Researchers in Canada and England found remission in 27 of 50 people in the program, or 54%, compared with two of 46 people receiving their usual care, about 4%.
The RESET for Remission trial involved 96 adults ages 18 to 45 who had obesity and had been diagnosed with type 2 diabetes within the previous six years. None was using insulin. Participants were randomly assigned to the program or usual care. The results do not show that the same approach will work for everyone with diabetes.
Remission is not a cure. In this study, it meant a blood test called HbA1c, which measures average blood sugar, was below the diabetes cutoff of 6.5%, with no blood-sugar-lowering medicine for at least 12 weeks. Blood sugar can rise again, and people still need medical checks. The Diabetes UK guidance stresses that remission is not known to be permanent.
This was much more than advice to eat better and take a walk. The program began with 12 weeks of a very low-calorie diet, largely using meal replacements, with regular monitoring by doctors and dietitians. It also included supervised walking and strength exercise twice a week and another exercise session on participants’ own. The next 12 weeks focused on returning to ordinary food, keeping weight off and continuing exercise.
Doctors managed medication changes and checked blood sugar and blood pressure throughout, restarting medicines when needed. Patients should not copy this diet or stop diabetes or blood pressure medicine on their own.
The researchers reported an adjusted odds ratio of 21.6 for remission. That is a statistical estimate after accounting for differences between the groups, not a statement that 21 times as many people reached remission. The actual results were 27 of 50 versus two of 46. The estimate was also imprecise, with a wide range of possible values.
Early side effects, including constipation, headache, dizziness and tiredness, were common in the program. No serious adverse events were reported. The Research Institute of the McGill University Health Centre said the next step is a larger, longer study.
This was a small, short study, not proof of lasting remission. Follow-up ended at 24 weeks, so it cannot tell families how long the benefit lasts after structured support stops. It also had no diet-only group, so the results cannot separate the effects of diet from those of supervised exercise.
JBizNews Desk | New York
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