“Reversing” prediabetes

[oldgreymare]

and what about people who achieve remission without weight loss?
or who get there before the "15 %" that Taylor seems to think is the magic figure?

As far as I can tell, all the research results from Prof Taylor group so far are from the DiRECT study. This is a small but rigorously followed up research project, however it focuses on overweight/obese individuals (BMI between > 27 and < 45, average weight 90-100 kg at start). The Newcastle diet protocol to achieve T2 remission worked for approximately 60% of participants and continued remission after 2 years does appear linked to maintaining > 10 kg weight loss in these individuals.

https://www.directclinicaltrial.org.uk/
https://www.directclinicaltrial.org.uk/Publications.html

Prof Taylor's group are now starting a different research trial to examine the potential to reverse T2 in normal weight individuals (BMI <27) called the ReTune study. But this is only just closing recruitment, so several years before we will have the results.

https://www.ncl.ac.uk/magres/research/diabetes/newstudy-retune/

 

[bulkbiker]

approximately 60% of participants and continued remission after 2 years does appear linked to maintaining > 10 kg weight loss in these individuals.

The 2 year remission (anything under 48 mmol/mol so not really "remission" to normality) was down to 36% of participants.

I have studied it fairly deeply which is why I rarely recommend starvation as a way to put T2 into reverse.

Crash diets aren't great for long term weight loss as many other studies have shown.

 

[oldgreymare]

The 2 year remission (anything under 48 mmol/mol so not really "remission" to normality) was down to 36% of participants.

I have studied it fairly deeply which is why I rarely recommend starvation as a way to put T2 into reverse.

Crash diets aren't great for long term weight loss as many other studies have shown.

Oops, I wasn't as clear as I should have been! Outcome of DiRECT trial after 24 months -

Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial http://eprints.gla.ac.uk/180894/

'....of those participants who maintained at least 10 kg weight loss (45 of 272 with data), 29 (64%) achieved remission; 36 (24%) of 149 participants in the intervention group maintained at least 10 kg weight loss. Serious adverse events were similar to those reported at 12 months, but were fewer in the intervention group than in the control group in the second year of the study (nine vs 22). Interpretation: The DiRECT programme sustained remissions at 24 months for more than a third of people with type 2 diabetes. Sustained remission was linked to the extent of sustained weight loss.' My emphasis. So the result is that the ND approach may help some individuals to achieve remission. But like you, I personally feel low carb may be a more sustainable

If I remember correctly, the rationale for the ND study was to see if this protocol can provide GPs with a more cost effective, less drastic approach to reverse prediabetes/T2 diabetes than recommending bariatric surgery. It will be interesting to see what comes out of the ReTune study.

But like you, I personally feel low carb may be a more sustainable and user friendly approach for most individuals to achieve and maintain remission.