Wed, Oct-02-19, 09:13
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Senior Member
Posts: 15,075
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Plan: mostly milkfat
Stats: 190/152.4/154
BF:
Progress: 104%
Location: Ontario
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https://www.sciencedaily.com/releas...90930114546.htm
Quote:
Type 2 diabetes remission possible with 'achievable' weight loss
People who achieve weight loss of 10% or more in the first five years following diagnosis with type 2 diabetes have the greatest chance of seeing their disease go into remission, according to a study led by the University of Cambridge.
The findings suggest that it is possible to recover from the disease without intensive lifestyle interventions or extreme calorie restrictions.
Type 2 diabetes affects 400 million people worldwide and increases the risk of heart disease, stroke, blindness and amputations. While the disease can be managed through a combination of positive lifestyle changes and medication, it is also possible for the high blood glucose levels that define diabetes to return to normal -- through significant calorie restriction and weight loss. An intensive low-calorie diet involving a total daily intake of 700 calories (less than one cheeseburger) for 8 weeks has been associated with remission in almost nine out of ten people with recently diagnosed diabetes and in a half of people with longstanding disease.
However, there is little evidence to show whether the same effect can be achieved by people undergoing less intensive interventions, which are more feasible and potentially scalable to the wider population. To answer this question, a team led by researchers at the University of Cambridge studied data from the ADDITION-Cambridge trial, a prospective cohort study of 867 people with newly diagnosed diabetes aged 40 and 69 years recruited from general practices in the eastern region.
The research was funded by Wellcome, the Medical Research Council and the National Institute for Health Research.
The researchers found that 257 participants (30%) participants were in remission at five-year follow-up. People who achieved weight loss of 10% or more within the first five years after diagnosis were more than twice as likely to go into remission compared to people who maintained the same weight.
"We've known for some time now that it's possible to send diabetes into remission using fairly drastic measures such as intensive weight loss programmes and extreme calorie restriction," says Dr Hajira Dambha-Miller from the Department of Public Health and Primary Care.
"These interventions can be very challenging to individuals and difficult to achieve. But, our results suggest that it may be possible to get rid of diabetes, for at least five years, with a more modest weight loss of 10%. This will be more motivating and hence more achievable for many people."
Senior author Professor Simon Griffin of the MRC Epidemiology Unit added: "This reinforces the importance of managing one's weight, which can be achieved through changes in diet and increasing physical activity. Type 2 diabetes, while a chronic disease, can lead to significant complications, but as our study shows, can be controlled and even reversed."
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So you can get a third of the effectiveness with a weaker approach... but I'd like to see how this breaks down. If you look at "personal fat threshold"--some people get in trouble at ten percent overweight, some at fifty or a hundred--diabetes-wise. If a three hundred pound person lost 30 pounds, that's a lot of potential fat storage freed up compared to what they're likely to be eating in a day. Or if a 150 pound person lost 15 pounds--that might bring them down to very low body fat levels, that's likely bringing them well below that personal fat threshold.
But okay--a person reaching the personal fat threshold where subcutaneous fat starts to be resistant to further growth, and ectopic fat depots (kidney, liver, etc) start to develop hasn't necessarily stopped growing their subcutaneous fat, it's just sort of slowed down. So for one person, that ten percent fat loss could bring them back under that threshold--but not for another person.
Quote:
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"These interventions can be very challenging to individuals and difficult to achieve. But, our results suggest that it may be possible to get rid of diabetes, for at least five years, with a more modest weight loss of 10%. This will be more motivating and hence more achievable for many people."
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Maybe... but it might be less motivating for a lot of people. "Do this, and a third of you will be successful..." or "do this and 90 percent will be successful." Do you feel lucky?
Quote:
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Our findings should inform discussions with people who have newly diagnosed Type 2 diabetes as motivation towards remission of the disease without restrictive and sometimes unachievable calorie restrictions.
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https://onlinelibrary.wiley.com/doi....1111/dme.14122
"Restrictive." "Unachievable." I think--letting people know that they don't have to go all in for some benefit is reasonable. Like--just because somebody can't bring themself to stop smoking entirely, that doesn't mean cutting smoking in half won't have some benefit. You shouldn't discourage somebody from doing some, it's not all or nothing. But that doesn't mean you should describe cutting out smoking entirely in negative terms. Also--I think people should have a little respect for what their patients might be capable of. Don't read to them from the LIttle Engine that Can't at every opportunity.
In the paper itself--HbA1c actually went down more in the non-remission group--it's just that they started higher than the remission group. So--starting closer to the finish line to start with helped people win the race.
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