(HealthDay News) — Intensive weight management implemented in primary care practices can result in remission of type 2 diabetes for almost half of patients, according to a study published in The Lancet.
Michael EJ Lean, MD, from the University of Glasgow in the United Kingdom, and colleagues randomized 49 primary care practices in a 1:1 ratio to provide a weight management program (intervention) or best-practice care by guidelines (control). A total of 306 individuals aged 20 to 65 years who had been diagnosed with type 2 diabetes in the past 6 years, had a body mass index of 27 to 45 kg/m², and were not receiving insulin were recruited.
The researchers recorded weight loss of 15 kg or more in 24 participants in the intervention group and none in the control group at 12 months (P < 0.0001). Diabetes remission was achieved by 46 and 4% of participants in the intervention and control groups, respectively (odds ratio, 19.7). In the whole study population, remission varied with weight loss; remission was achieved by none of those who gained weight, 7, 34, 57, and 86% of participants who maintained 0 to 5 kg weight loss, had 5 to 10 kg weight loss, had 10 to 15 kg weight loss, and who lost 15 kg or more, respectively.
“Remission of type 2 diabetes is a practical target for primary care,” the authors write.
Several disclosed financial ties to the pharmaceutical and weight loss industries.
Lean MEJ, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The Lancet. 2017 Dec 5. doi: 10.1016/S0140-6736(17)33102-1