New research suggests that only a small percentage of individuals with type 2 diabetes (T2D) manage to achieve and maintain diabetes remission through weight loss alone.
Among over 37,000 individuals with T2D in Hong Kong, merely 6% experienced sustained diabetes remission solely through weight loss, even up to 8 years post-diagnosis. However, a significant portion of those who initially achieved remission had hyperglycemia recurring within 3 years.
The study, led by Andrea Luk, MD, of The Chinese University of Hong Kong, highlights the challenges of sustaining diabetes remission in real-world scenarios. It underlines that over 80% of diabetes remissions occur within the initial 5 years post-diagnosis, with declining beta cell function making remission increasingly difficult over time, despite weight reduction efforts.
Published in PLOS Medicine on January 23, 2024, the study emphasizes the importance of early weight management interventions for T2D patients, echoing recent clinical trials demonstrating the potential of T2D remission through sustained weight loss, either via bariatric surgery or lifestyle interventions.
Analyzing data from the Risk Assessment and Management Programme-Diabetes Mellitus (RAMP-DM), which included 37,326 newly diagnosed T2D patients from 2000 to 2017, the study observed that greater weight loss within the first year after diagnosis correlated with higher rates of sustained remission. Notably, individuals who lost 10% or more of their body weight were most likely to achieve remission.
Despite these promising observations, the study acknowledges the challenges of maintaining remission in real-world settings. It highlights that structured programs with intensive lifestyle interventions, regular monitoring, and holistic diabetes management may yield higher remission rates compared to real-world scenarios.
Furthermore, the study found that a considerable proportion of individuals who achieved diabetes remission eventually relapsed into hyperglycemia within a few years. However, diabetes remission was associated with a decreased risk of all-cause mortality by 31%.
The study underscores the role of policymakers in designing and implementing early weight management interventions for T2D patients and emphasizes clinicians’ role in guiding patients towards healthy lifestyle choices. While acknowledging the difficulty of achieving and maintaining diabetes remission, clinicians are encouraged to consider pharmacotherapy and metabolic surgery for weight management in suitable individuals.
Dr. Mona Mshayekhi from Vanderbilt University Medical Center comments that the study’s findings resonate with clinical experiences in the US, emphasizing the challenges of sustained weight loss in real-world settings. She highlights the potential of newer weight-management strategies, such as glucagon-like peptide 1 receptor agonists, in facilitating higher rates of diabetes remission in future studies.
In conclusion, the study underscores the importance of addressing obesity and providing comprehensive diabetes care to improve outcomes and reduce the burden of T2D. Please consult with your healthcare professional for personalized guidance and in-depth information regarding diabetes management, weight loss strategies, and treatment options tailored to your individual health needs and circumstances.
