Type 2 diabetes: remission in just a week

Yki‐Järvinen, Hannele

doi:10.1007/s00125-011-2266-6

Cited by 14 publications

(7 citation statements)

References 17 publications

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“…The question of possible therapeutic application of VLCD for T2DM was raised immediately on publication of the Counterpoint study (36). The present data confirm reversal of T2DM for at least 6 months in those who achieve nondiabetic plasma glucose levels after VLCD.…”

Section: Discussionsupporting

confidence: 63%

Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders

et al. 2016

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OBJECTIVEType 2 diabetes mellitus (T2DM) is generally regarded as an irreversible chronic condition. Because a very low-calorie diet (VLCD) can bring about acute return to normal glucose control in some people with T2DM, this study tested the potential durability of this normalization. The underlying mechanisms were defined. RESEARCH DESIGN AND METHODSPeople with a T2DM duration of 0.5-23 years (n = 30) followed a VLCD for 8 weeks. All oral agents or insulins were stopped at baseline. Following a stepped return to isocaloric diet, a structured, individualized program of weight maintenance was provided. Glucose control, insulin sensitivity, insulin secretion, and hepatic and pancreas fat content were quantified at baseline, after return to isocaloric diet, and after 6 months to permit the primary comparison of change between postweight loss and 6 months in responders. Responders were defined as achieving fasting blood glucose <7 mmol/L after return to isocaloric diet. RESULTSWeight fell (98.0 6 2.6 to 83.8 6 2.4 kg) and remained stable over 6 months (84.7 6 2.5 kg). Twelve of 30 participants achieved fasting plasma glucose <7 mmol/L after return to isocaloric diet (responders), and 13 of 30 after 6 months. Responders had a shorter duration of diabetes and a higher initial fasting plasma insulin level. HbA 1c fell from 7.1 6 0.3 to 5.8 6 0.2% (55 6 4 to 40 6 2 mmol/mol) in responders (P < 0.001) and from 8.4 6 0.3 to 8.0 6 0.5% (68 6 3 to 64 6 5 mmol/mol) in nonresponders, remaining constant at 6 months (5.9 6 0.2 and 7.8 6 0.3% [41 6 2 and 62 6 3 mmol/mol], respectively). The responders were characterized by return of first-phase insulin response. CONCLUSIONSA robust and sustainable weight loss program achieved continuing remission of diabetes for at least 6 months in the 40% who responded to a VLCD by achieving fasting plasma glucose of <7 mmol/L. T2DM is a potentially reversible condition.

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Section: Discussionsupporting

confidence: 63%

Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders

et al. 2016

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“…Increased LFU could augment lipid oxidation. The decrease in insulin levels, as seen postoperatively, could be predicted to decrease LFC by diverting FFA flux from lipogenesis to oxidation (14).…”

Section: Discussionmentioning

confidence: 99%

Increased Liver Fatty Acid Uptake Is Partly Reversed and Liver Fat Content Normalized After Bariatric Surgery

et al. 2017

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“…However, even though calorie restriction may play a role early after surgery, food intake increases over time after bariatric surgeries and patients generally resume a level of caloric intake that is much higher than the extreme calorie restriction needed to produce and maintain a normal carbohydrate metabolism in diabetic patients. As Yki-Järvinen [41] puts it: "remission in a week may not be a cure for life. "…”

Section: Discussionmentioning

confidence: 97%

The Effect of Gastrointestinal Surgery on Insulin Resistance and Insulin Secretion

Castagneto

Mingrone

2012

Curr Atheroscler Rep

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Diabesity is a term often used to indicate the association of type-2 diabetes mellitus (T2DM) with obesity; the prevalence of both conditions is rapidly increasing worldwide and has reached epidemic proportions. Insulin resistance represents the major determinant of T2DM, which becomes manifest once relative β-cell failure ensues and insulin secretion is no longer sufficient to compensate for insulin resistance. In recent years, gastrointestinal surgery has emerged as the most effective option for the treatment of obesity and diabetes, with level-1 evidence of diabetes remission. Restrictive gastric operations such as gastric banding can improve insulin resistance in proportion to weight loss, while gastrointestinal bypass procedures, such as roux-en-y gastric-bypass (RYGB) and biliopancreatic diversion (BPD), can improve glucose homeostasis even before a significant weight loss is reached, suggesting weight-independent mechanisms of action. Studies comparing RYGB to BPD show that RYGB primarily enhances insulin secretion and reduces hepatic glucose output, whereas BPD rapidly improves glycemia primarily through the normalization of insulin sensitivity. Given the fact that BPD involves a significantly longer bypass of the proximal intestine than RYGB, these data suggest that the exclusion of a greater length of small bowel from the transit of food may cause broader and more profound influence on insulin sensitivity.

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Type 2 diabetes: remission in just a week

Cited by 14 publications

References 17 publications

Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders

Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders

Increased Liver Fatty Acid Uptake Is Partly Reversed and Liver Fat Content Normalized After Bariatric Surgery

The Effect of Gastrointestinal Surgery on Insulin Resistance and Insulin Secretion

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