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How does weight loss 'fix' type 2 diabetes?

ISLAMABAD -- In type 2 diabetes, the pancreas does not make enough insulin, which is the hormone that helps regulate blood sugar levels. Until recently, it was believed that diabetes lasts for life, but a new trial suggested that weight loss can send diabetes into remission. Researchers may now have learned why this happens.

A new study asks how weight loss can send diabetes into remission, and what happens when it doesn't. A recent clinical trial (the Diabetes Remission Clinical Trial [DiRECT]) - the results of which were published last year in The Lancet - discovered that nearly half of the participants with type 2 diabetes who followed a weight loss program experienced the remission of their condition by the end of the study. Traditionally, specialists thought of diabetes as a condition to be managed rather than cured,so these new findings offer fresh insight into how type 2 diabetes could be counteracted using a tool within anyone's reach: diet and lifestyle choices. Still, after the trial's results were published, a question remained unanswered: "Why would weight loss lead to diabetes remission in some people?"

Now, researcher Roy Taylor - from Newcastle University in the United Kingdom - who oversaw DiRECT, together with colleagues from various academic institutions, claim that they may have found the answer. Their observations were published in the journal Cell Metabolism. Weight loss can normalize blood sugar For DiRECT, the researchers recruited participants who had been diagnosed with type 2 diabetes within 6 years from the start of the trial. For the study, the volunteers were randomly split into two groups: some were assigned bestpractice care, acting as the control group, while others joined an intensive weight management program while still receiving appropriate care for diabetes. Type 2 diabetes, obesity may soon be reversed with gene therapy Can gene therapy offer a solution to diabetes? After 1 year from the start of the trial, 46 percent of those assigned to the weight loss program had managed to recover and maintain normal blood sugar levels.

According to the researchers, the participants in the second group who did not achieve these results had not lost enough weight to do so, but still it remained unclear why their metabolisms had not responded to the regimen in the same way. Now, Taylor and team suggest that the people who responded well to the weight loss program showed early, sustained improvement in the functioning of a type of pancreatic cell known as beta cells, which are tasked with the production, storage, and release of insulin. And in this idea lies a new challenge to previously held beliefs; specialists had always thought that, in type 2 diabetes, pancreatic beta cells are destroyed, contributing to the development of the condition. "This observation carries potentially important implications for the initial clinical approach to management," notes Taylor. "At present," he adds, "the early management of type 2 diabetes tends to involve a period of adjusting to the diagnosis plus pharmacotherapy with lifestyle change.

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Publication:The Messenger (Karachi, Pakistan)
Date:Aug 4, 2018
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