Diabetes: cure by losing weight

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

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Type 2 diabetes accompanies most people with it for the rest of their lives. Patients who have only suffered from it for a few years have a good chance of getting rid of the diabetes again. To do this, however, they have to do one thing: slim down properly, preferably in the first few years of the disease.

Type 2 diabetes mostly affects overweight people. And patients who do not yet fall into this category in terms of their BMI are generally a bit fuller around the abdomen. Abdominal fat in particular plays a central role in the development of the disease - among other things, it sends messenger substances into the body that promote inflammatory processes.

Conversely, the loss of adipose tissue in this area can apparently also reverse the disease process. Doctors refer to such a turnaround as remission.

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Researchers led by Roy Taylor from Newcastle University put 64 type 2 diabetics on a strict diet over a period of twelve months. All participants were diagnosed less than six years ago, and while patients needed low-sugar medication, they did not yet need to inject insulin.

On average, the subjects lost ten kilograms during the observation period. In almost half of them (46 percent), the blood sugar metabolism returned to normal as a result of the weight loss.

Beta cells can recover

In fact, Roy Taylor's team found that the function of the insulin-producing beta cells in the healed patients had improved rapidly and substantially. The study thus refutes the common notion that once the function of these cells has been lost, it is irretrievably lost in diabetes patients.

Healthy beta cells respond to an increase in blood sugar in two phases with insulin release: The first surge occurs within the first ten minutes after the increase in blood sugar. In patients with type 2 diabetes, this crucial first flare usually does not occur at all.

“We now know that the old idea that beta cells perish in diabetes is incorrect. Instead, the activity of their genes, which are responsible for insulin production, changes, ”says study leader Taylor when asked by

Fat deposits stress the cells

The reason for this is that too much fat accumulates in the pancreas in the patient. At the cellular level, this causes stress. "When the causes of the metabolic stress, that is, the fat deposits, are reduced, the genes start up again and the cells can resume their specialized functions," explains Taylor. Scientists call this process “redifferentiation”.

The researchers examined to what extent the convalescent differed from the subjects who remained diabetic. They found that the weight loss was comparable in both groups; the blood lipid levels and the percentage of fat deposits in the liver and pancreas, in which the insulin-producing cells are located, had also decreased to a comparable extent with the pounds lost.

Shorter duration of illness, better chances

However, the participants differed on one point: Patients whose diabetes was in remission had received the diagnosis on average 2.7 years before the start of the study. For participants whose metabolism did not return to normal, the average was 3.8 years.

“If the cellular stress lasts too long due to the stored fat, the cells can no longer activate the insulin genes. They become null cells. In other words, they are alive, but have lost their specialized function, ”explains the scientist.

Change of strategy for diabetes therapy?

The results of the study speak strongly in favor of turning away from conventional therapy strategies for diabetes. So far, people have relied on medication in combination with a moderate change in lifestyle. But that seems to be the wrong way to go: Patients who were treated according to this standard for one year as part of the study remained diabetic and dependent on medication. On the other hand, working as early as possible at the onset of the illness and losing substantial weight could save many from a lifelong illness.

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