Prediabetes, a precursor to type 2 diabetes, can be put into remission by reducing visceral abdominal fat so that blood sugar levels return to normal. Such a remission not only protects against type 2 diabetes in the long term, it also improves kidney and vascular function.
A new study involving experts from the German Center for Diabetes Research (DZD) examined the mechanisms through which weight loss can lead to remission of prediabetes. The results are published in the English-language journal “The Lancet Diabetes & Endocrinology”.
Reverse diabetes?
Type 2 diabetes is relatively common and increases the risk of developing a heart attack, kidney and eye disease, and various forms of cancer. Prediabetes is the precursor to type 2 diabetes.
Although type 2 diabetes has long been considered irreversible, both prediabetes and type 2 diabetes can be brought into remission through significant weight loss. The experts explain that those affected are healthy, but not really cured.
The remission achieved often does not last long-term, which means that many affected people develop type 2 diabetes again within a few years (usually after around five years). It is therefore important to bring prediabetes into remission before those affected even develop type 2 diabetes.
How does weight loss work for prediabetes?
The experts conducted a large study with a total of 1,105 participants who suffered from prediabetes. To put the disease into remission, participants took part in a weight loss program that lasted one year. Particular emphasis was placed on a healthy diet and more exercise.
It turned out that among the participants who achieved a weight loss of at least five percent, not all achieved remission of their prediabetes, even though the amount of relative weight loss was the same for all participants, according to the team.
Thus, weight loss did not appear to be responsible for the remission. The researchers also found that participants who achieved remission had better insulin sensitivity.
What role does belly fat play in remission from prediabetes?
And not only were these people more sensitive to insulin, they had also lost more visceral abdominal fat, a type of fat found right in the abdominal cavity and surrounding the intestines. According to experts, it is known that visceral abdominal fat can influence insulin sensitivity, which is triggered, for example, by an inflammatory reaction in fatty tissue.
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The researchers also found that there were no differences in liver fat reduction between participants who achieved remission and participants who did not. This is surprising because liver fat is also considered an important risk factor for diabetes.
New therapeutic target for the treatment of prediabetes
This finding suggests that in people with prediabetes, reducing visceral abdominal fat plays a critical role in remission, and reducing this type of fat in particular should be a therapeutic goal for treating prediabetes, the team reports.
Participants who achieved remission of their prediabetes within the study period benefited from a greatly reduced risk (73 percent) of type 2 diabetes up to two years after the end of the program, and their kidney function and the condition of their blood vessels also improved significantly, say the researchers.
The likelihood of remission from prediabetes increases if body weight is reduced by five percent and women lose around four centimeters of their waist circumference and men lose around seven centimeters of their waist circumference.
“Based on the new data, remission should be the new therapeutic goal in people with prediabetes. “This has the potential to change treatment practice and minimize the complication rate for our patients,” adds study author Professor Dr. Reiner Jumpertz von Schwartzenberg from the University of Tübingen added in a press release. (as)
