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Research news from the EASD: Putting type 2 diabetes into remission

Prof Roy Taylor

This year’s virtual European Association for the Study of Diabetes (EASD) conference brought together thousands of researchers to share their latest discoveries and knowledge.

We've shared EASD highlights before on the latest research that will help people with diabetes live better and more confident lives. This includes preventing type 2 diabetes, improving diabetes care and curing and preventing other forms of the condition

Today, we cover new research that will help more people go into and keep their type 2 diabetes in remission.

Turn up the volume

One of the biggest headlines from EASD 2020 was the new research from Professor Roy Taylor and his team. His group showed how remission from type 2 diabetes brings the pancreas back to a near healthy size and shape. We’ve known for a while that the pancreas in people with type 2 diabetes is around 20-30% smaller than in people who don't have it. It also has a different shape to normal. But it’s never been clear if this is the cause or a result of developing type 2 diabetes.

The researchers looked at 64 participants from the DiRECT trial. This trial looks at using low-calorie diets to put type 2 diabetes in to remission. They used MRI scanners to measure the shape, size and amount of fat in the pancreas, and see how it changed during the trial.

After two years on the trial, they found that the size of the pancreas had increased by 20% in people who went into remission - almost to normal size. Their pancreas shape was also completely back to normal, and levels of fat in the pancreas fell. In people who didn’t go into remission though, the size and shape of the pancreas didn't change as much.

This is the first evidence we have that type 2 diabetes remission helps to restore the health of the whole pancreas. Professor Taylor said “It will be enormously encouraging for anyone with type 2 diabetes to learn that their small pancreas can return to normal size. Knowing what a treatment actually does inside the body is both motivating and reassuring.”

A surgical approach to remission?

Weight loss is key to putting type 2 diabetes into remission. For some people, diet and exercise can help to shift excess weight. But others may need to take a different approach. Weight loss surgery (bariatric surgery) is one of the other ways people with obesity and type 2 diabetes can lose weight and go into remission.

A team from the University of Pisa has been looking at who is most likely to stay in remission long-term following bariatric surgery. They followed 85 people with type 2 diabetes for ten years after they had the surgery. Every year, their fasting blood sugar and HbA1c levels were checked to see how long they stayed in remission.

The results showed that ten years after surgery, over half of the people (56%) were in remission, with an HbA1c level of less than 6.5%. The researchers found that people who had had the surgery within five years of their diabetes diagnosis, and those who were not using insulin, were more likely to go into and stay in remission.

As part of our new strategy, we want more people to put their type 2 diabetes into remission. Key to this is helping people to find an approach to remission that works for them. Research like this shows that bariatric surgery can help some people go into remission and stay there. It sheds light on the types of people who might benefit the most from this approach. But we also know that there are other ways to go about going into remission. We’re working to make more options available to more people, to give as many people as possible the chance to go into remission.

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