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Type 2 diabetes ‘reversed by intensive lifestyle intervention’

An intensive lifestyle change programme alongside drug therapy for people with type 2 diabetes reduced their Hb1AC levels back to normal and even brought about complete remission in some patients, a study has shown.

The randomised controlled trial, carried out by researchers in Canada, included just over 80 patients who were assigned to take part in an intensive diet and exercise programme while taking insulin glargine, metformin and acarbose, or to receive standard care for a duration of either eight or 16 weeks.

At the end of the eight- and 16-week study periods, patients stopped taking their diabetes drugs and were encouraged to continue with lifestyle modifications while having their blood glucose tested regularly for just under a year.

In the eight- and 16-week groups, 50% and 70% of patients respectively assigned to the intervention achieved normal glucose levels in the final week of treatment, compared with just 4% in each control group.

According to HbA1C criteria for diabetes remission, 21% of patients receiving the intervention for eight weeks and 41% of those who received it for 16 weeks had partial or complete remission of their diabetes at 12 weeks post-intervention.

Lead author Dr Natalie McInnes, endocrinologist and assistant professor at MacMaster University, said: 'The finding that up to 41% of the intervention group participants maintained partial or complete diabetes remission 12 weeks after stopping diabetes drugs challenges the notion that type 2 diabetes is a permanent and progressive disease as previously thought, and suggests that it might be possible to achieve diabetes remission by using a combination of lifestyle and pharmacological approaches.'

J Clin Endocrinol Metab 2017; available online 15 March

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