Lifestyle interventions with successful weight loss can reverse type 2 diabetes. Such remission is associated with a significant reduction in the risk of cardiovascular disease and chronic kidney disease.
A new study involving experts from Imperial College London examined the success of lifestyle interventions for diabetes and assessed the impact of achieved remissions on the risk of chronic kidney and cardiovascular disease. The results can be read in the specialist journal “Diabetologia”.
Effects examined over 12 years
The more than 4,000 participants in the study were on average 59 years old, 58 percent female and overweight or obese – with an average BMI of 35.8 kg/m2, i.e. in the severe obesity range. They had also suffered from type 2 diabetes for an average of six years.
The team analyzed participants’ long-term results in remissions and remission duration over a twelve-year period. Remission was considered to have been achieved when diabetes medication was no longer required and the HbA1c value was below 48 mmol/mol.
In addition, the incidence of cardiovascular disease and chronic kidney disease associated with remission was assessed.
Reduced risk of cardiovascular and kidney diseases
In general, according to the researchers, three main results were observed in relation to remission in diabetes:Long-term remission is difficult to achieve.Even short periods of remission have a positive effect.Under certain conditions, the probability of remission increases.
Long-term remission difficult to achieve
Although 18 percent of participants achieved temporary remission, the proportion of participants with a sustained remission until the eighth year of the study was only three percent, according to the research team. This suggests how difficult it is to manage diabetes long-term through lifestyle interventions.
Short-term successes also count
However, even participants who only achieved short remission episodes during the follow-up period had a 33 percent lower risk of chronic kidney disease and a 40 percent lower risk of cardiovascular disease, compared to people who did not achieve remission, the researchers report.
According to the experts, the reduction in risk was even greater if the participants had remission over a period of at least four years. This led to a 55 percent reduced risk of chronic kidney disease and a 49 percent reduced risk of cardiovascular disease.
What influences success?
As an explanation for these results, the experts cite improvements in weight, physical fitness as well as HbA1c levels and LDL cholesterol through the lifestyle interventions.
According to the experts, remission was most likely in participants who had only had diabetes for a short time, had a low initial HbA1c value and had lost a lot of weight.
“While our study also serves as a reminder that it is difficult to maintain weight loss and remission, the results show that any success in remission is associated with later health benefits,” study author Professor Edward Gregg added in a press release. (as)