Remission of Type 2 Diabetes
Type 2 diabetes is not necessarily permanent. There is increasing evidence to show that people with overweight or obesity can achieve remission – in other words, no longer having type 2 diabetes, having normal HbA1c results, and not needing diabetes medications – through sustained, substantial weight loss.
How does weight loss help achieve diabetes remission?
Scientists believe that storing too much fat in the liver and pancreas affects how type 2 diabetes develops, and losing this fat can help put your diabetes into remission.
In fact, losing at least 15kg significantly increases your chances of type 2 diabetes remission.
We also know remission is most likely to occur closer to your initial diagnosis, so it is important to start your remission journey as early as possible.
We do not yet know how long remission will last, but the key is maintaining the weight loss and possibly losing more weight at a later stage.
Achieving remission may prevent, or at least delay, the complications of diabetes, but we cannot guarantee that they will be avoided for all patients as other factors may apply
Is there a special diet to help achieve diabetes remission?
The best diet is the one that you can stick to. There are a lot of different ways to lose weight – but there is no ‘one-size-fits-all’ diet. A recent study called the ADDITION trial showed that if you have type 2 diabetes diagnosed within 5 years then losing just 10% of your body weight, regardless of diet followed can result in remission of diabetes.
However, we do know that many people have achieved remission by losing weight following a low-carbohydrate diet or by following a low-calorie meal -replacement programme.
Very low-calorie meal-replacement programme
A study called DiRECT showed that 86% of patients who had lost at least 15 kg of weight using very low-calorie meal replacements (850 calories a day) achieved type 2 diabetes remission. In a similar study, the DIADEM-1 trial, 61% of participants who followed a very low calorie total meal replacement diet lost an average of 12kg and achieved type 2 diabetes remission.
This is no quick fix, and the diet can be incredibly challenging. You will need expert support from trained healthcare professionals right from the start. However, this programme has been shown to be effective in maintaining diabetes remission for up to two years.
Low-carbohydrate (low-carb) programme
A low-carbohydrate lifestyle has also been demonstrated to induce remission and improve blood-glucose control, blood pressure and lipid profiles in adults with type 2 diabetes.
Weight-loss (bariatric) surgery
There is a lot of evidence that weight loss following bariatric surgery can result in remission of type 2 diabetes in up to 60% of patients and this can be maintained for several years providing weight loss is also maintained.
It is important to know that not everyone who loses this much weight will be able to put their diabetes into remission. But losing 15kg comes with a lot of health benefits, even if you do not achieve remission. Additionally, maintaining diabetes remission involves long-term behaviour change. If you go back to old habits and regain the weight that you have lost, your HbA1c and blood sugars may rise again
If you are considering trying any of these options, please consult your healthcare team for more information.
Dr Mohgah Elsheikh