Remission of Type 2 Diabetes

Chan, Catherine B.; Dasgupta, Kaberi; Dominy, Cliff; Gautier, Michel; Jin, Susie; Little, Jonathan P.; McInnes, Natalia; Reichert, Sonja M.; Bajaj, Harpreet S.; Gilbert, Jeremy; Houlden, Robyn L.; Kim, James; MacDonald, Barbara; MacKay, Dylan; Mansell, Kerry; Rabi, Doreen M.; Sherifali, Diana

doi:10.1016/j.jcjd.2022.10.004

Cited by 18 publications

(33 citation statements)

References 59 publications

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“…In short, if LSI is instituted as remission therapy of T2D, followup at 6 months intervals is necessary. 7 However, if LSI-alone decreases glucose levels below diabetic thresholds for a substantial period of time, then better health and decreased costs could result. 27…”

Section: Discussionmentioning

confidence: 99%

“…In accordance with current guidelines, we report remission as a single number, meaning the transition from T2D to either prediabetes or NGT. 7,34,35 Second, remission criteria were not uniform across studies. Some investigations used the OGTT, others used fasting plasma glucose (FPG) or glycated hemoglobin A1C (A1C) and still others used a combination of A1C and FPG.…”

Section: Remission Ratesmentioning

confidence: 99%

“…[1][2][3][4] The new question is: does LSI have a role in achieving T2D remission. [5][6][7] For sub-Saharan Africa, the value in determining whether LSI can achieve T2D remission is potentially enormous. By 2045 year, the number of Africans living with T2D will increase from 24 million to 55 million.…”

Section: Introductionmentioning

confidence: 99%

“…8,15 To develop policy about the use of LSI-alone as a therapeutic modality for T2D remission, a consensus based on numerous, high-quality studies is required. 7 However, studies on whether LSI-alone will induce remission of T2D are few.…”

Section: Introductionmentioning

confidence: 99%

“…Searches of previous reviews and meta-analyses of LSI designed to reverse T2D revealed that LSI trials were not divided into two groups: newly diagnosed, treatment-naive T2D and established T2D. 6,7,17 As both enrollment criteria and the actual elements of LSI interventions may differ depending on whether T2D is newly diagnosed or established, trials in this scoping review were divided into two groups: newly diagnosed or established T2D.…”

Section: Introductionmentioning

confidence: 99%

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A Scoping Review of Trials Designed to Achieve Remission of Type 2 Diabetes with Lifestyle Intervention Alone: Implications for Sub-Saharan Africa

Karera¹,

Wentzel²,

Ishimwe³

et al. 2023

DMSO

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According to the International Diabetes Federation, sub-Saharan Africa is experiencing the highest anticipate increase in the prevalence of type 2 diabetes (T2D) in the world and has the highest percent of people living with T2D who are undiagnosed. Therefore, diagnosis and treatment need prioritization. However, pharmacological hypoglycemics are often unavailable and bariatric surgery is not an option. Therefore, the ability to induce T2D remission through lifestyle intervention alone (LSI-alone) needs assessment. This scoping review evaluated trials designed to induce T2D remission by LSI-alone. PubMed, Embase, Cochrane, and CINAHL databases were searched for trials designed to induce T2D remission through LSI-alone. Of the 928 identified, 63 duplicates were removed. With abstract review, 727 irrelevant articles were excluded. After full-text review, 112 inappropriate articles were removed. The remaining 26 articles described 16 trials. These trials were published between 1984 and 2021 and were conducted in 10 countries, none of which were in Africa. Remission rates varied across trials. Predictors of remission were 10% weight loss and higher BMI, lower A1C and shorter T2D duration at enrollment. However, LSI-alone regimens for newly diagnosed and established T2D were very different. In newly diagnosed T2D, LSI-alone were relatively low-cost and focused on exercise and dietary counseling with or without calorie restriction (~1500 kcal/d). Presumably due to differences in cost, LSI-alone trials in newly diagnosed T2D had higher enrollments and longer duration. For established T2D trials, the focus was on arduous phased dietary interventions; phase 1: low-calorie meal replacement (<1000 kcal/day); phase 2: food re-introduction; phase 3: weight maintenance. In short, LSI-alone can induce remission in both newly diagnosed and established T2D. To demonstrate efficacy in Africa, initial trials could focus on newly diagnosed T2D. Insight gained could provide proof of concept and a foundation in Africa on which successful studies of LSI-alone in established T2D could be built.

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Section: Discussionmentioning

confidence: 99%

Section: Remission Ratesmentioning

confidence: 99%