Piloting a Remission Strategy in Type 2 Diabetes: Results of a Randomized Controlled Trial

Abstract

A short course of intensive lifestyle and drug therapy achieves on-treatment normoglycemia and promotes sustained weight loss. It may also achieve prolonged, drug-free diabetes remission and strongly supports ongoing studies of novel medical regimens targeting remission.

Effect of Intensive Weight Loss Programs on Diabetes Remission in Newly Diagnosed Patients with Type 2 Diabetes: A Systematic Review

“…One used low calorie diet, with a subsequent lifestyle program for weight loss maintenance [15]. The other combined lifestyle treatment with an initial period of oral antidiabetic drugs, subsequently transitioned to lifestyle treatment only [16].…”

“…This systematic literature search identified two studies comparing the effects of intensive weight loss programs with standard diabetes care with respect to remission of type 2 diabetes [15,16]. One used low calorie diet and the other used energy reduced 'normal' diet and exercise combined with initial anti diabetic drug treatment.…”

“…Of these 5 articles, one was excluded due to inappropriate control treatment [13], one because it did not meet the criteria for RCT [9] and one because it was a subgroup analysis of an already included article [14]. Two articles finally met the inclusion criteria [15,16].…”

“…The second study [16], a Canadian study by McInnes et al, was a randomized controlled study aimed at investigating feasibility, safety and potential for inducing remission by use of a short-term intensive metabolic intervention combined with modest weight loss. Remission was defined as HbA1c <6.0% (42 mmol/mol), and partial remission as <6.5% (48 mmol/mol), both in the absence of oral antidiabetic drugs.…”

Amylase

“…Amylase inhibitors particularly Acarbose, a pseudotetrasacharide, have been used it the treatment of type 2 diabetes where they have moderate effects to reduce peak postprandial glucose and Hemoglobin A1c. Normally, they are used as a second line medication often in conjunction with metformin (36). Evidence also exists that Acarbose can reduce dumping syndrome after bariatric surgery (11).…”