Report suggests possible remission of type 2 diabetes through weight loss

Experts, in a report published in the BMJ yesterday suggest that for many patients type 2 diabetes could be reversed with a sustained weight loss of about 15 kg.

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According to Louise McCombie and colleagues from the University of Glasgow, doctors and patients might not realize that in many cases type 2 diabetes could be reversed; therefore, to improve health outcomes and decrease the costs of health care, they are calling for greater awareness, surveillance of remissions and documentation.

In UK, nearly 3.2 million people are presently affected with type 2 diabetes. The National Health Service currently spends around £1bn (€1bn; $1.3bn) per year (£22m per day) on antidiabetes drugs, and due to the rise in rates of diabetes cases as well as drug prices, the costs are increasing.

Existing guidelines recommend the reduction of blood sugar levels and cardiovascular risks, mainly through drugs and general lifestyle changes. Although, as noted by the authors, complications are still developed by most of the patients and in comparison with people without diabetes, the life expectancy of such patients is nearly 6 years shorter.

A diagnosis of type 2 diabetes possesses great social and financial consequences for the patients, as well as poorer health predictions.

On the contrary, the report provides evidence for the association of weight loss with extended life expectancy for diabetics and indicates that a nearly 15 kg of weight loss could produce total remission of type 2 diabetes.

Apart from health benefits, achieving remission might provide a strong sense of personal accomplishment and empowerment, eliminate stigma, and also reduce insurance premiums.

But, according to the authors, remission is less frequently recorded.

For instance, the findings of a US study that followed 120,000 patients for 7 years and indicated remissions of only 0.14%. Similarly, the Scottish Care Information Diabetes database that keeps a record of every diabetic patient in Scotland indicated that less than 0.1% were coded as being in remission.

The authors point out that the lack of accepted guidance and criteria for recoding patients as being in remission, might have led to hesitation and a lack of reported cases. Further, according to the researchers, a major cause for low recording might be due to less patients attempting or achieving remission.

They, explaining the need of official guidelines and international consensus in recording diabetes in remission, and concluded: "Appropriate coding will make it possible to monitor progress in achieving remission of type 2 diabetes nationally and internationally and to improve predictions of long term health outcomes for patients with a known duration of remission."

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