Type 2 diabetes and clinical trials

Many participants of DiRECT found reintroduction of food and subsequent weight-loss maintenance to be more challenging than the 800 calorie total meal replacement phase, the investigators report.

Outwardly lean people who have type 2 diabetes have increased intra-organ fat, reductions in which occur in line with weight loss-induced diabetes remission, say researchers.

The so-called legacy effect of a period of good glycemic control in type 2 diabetes may be because the greatest impact of hyperglycemia occurs many years in the future, show data from the UKPDS.

Blood pressure falls markedly when people with type 2 diabetes undertake a very-low-calorie diet, and immediate withdrawal of antihypertensive medications has few ill effects, say the DiRECT investigators.

Women naturally have lower levels of hepatic and pancreatic fat than men, but having type 2 diabetes removes this advantage and confers a relatively larger increase in cardiovascular risk, show further data from DiRECT.

Ghrelin is the only appetite-related hormone that predicted weight regain among the participants of the DiRECT trial, say the researchers.

Sustained remission of type 2 diabetes in DiRECT was accompanied by normalization of pancreatic morphology, say the researchers.

The strongest predictor of type 2 diabetes remission is weight loss, with other variables only modestly associated with outcome and insufficient to identify people unsuitable for attempting this goal, shows a post-hoc analysis of DiRECT data.

The DIADEM-I randomized trial demonstrates substantial remission of type 2 diabetes in people from the Middle East and in north Africa after they undertake a total meal-replacement very-low-calorie diet.

The very-low-calorie diet intervention used in the DiRECT trial is feasible and associated with type 2 diabetes remission in residents of Barbados, researchers report.

People who achieved sustained remission of type 2 diabetes via substantial weight loss in the DiRECT trial regained normal maximal beta-cell capacity, the investigators report.

Type 2 diabetes remission can be achieved within 1 year at a cost below the average annual cost of diabetes management, even when including complications, shows an economic evaluation of the DiRECT/Counterweight-Plus weight management program.

Just over a third of people who undertook a period on a very-low-calorie diet in the DiRECT trial to tackle type 2 diabetes are in remission 24 months later, the investigators have reported.

Findings from the CARMELINA trial suggest that the dipeptidyl peptidase-4 inhibitor linagliptin has a similar cardiovascular safety profile to placebo when added to standard care in high-risk type 2 diabetes patients.

Losing weight in the CAMELLIA-TIMI 61 trial was associated with a significantly reduced risk for developing type 2 diabetes, the investigators have reported at the 54th EASD Annual Meeting in Berlin, Germany.

Research suggests that giving patients with type 2 diabetes intensive blood pressure treatment as per the ACCORD BP study would be beneficial in a real-world US population.

Researchers from the DiRECT trial have reported large positive effects on liver fat and insulin secretion among people who achieved type 2 diabetes remission in response to a very-low-calorie diet.

Interleukin-1 beta inhibition with canakinumab does not prevent the development of type 2 diabetes, a secondary analysis of data from CANTOS shows.

Nearly half of the patients helped to follow a very-low-calorie diet for at least 3 months achieved and maintained remission of type 2 diabetes over the 12 months of the DiRECT trial, the investigators report.

A meta-analysis shows that although medications and lifestyle changes can both reduce the risk for type 2 diabetes in high-risk patients, only lifestyle modifications have a sustained effect.