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Lifestyle changes mean that medication for type 2 diabetes can be avoided
Until recently, it was assumed that type 2 diabetes had to be treated with medication or insulin for life. But it is now known that the disease can be managed without medication. Is the metabolic disease possibly curable?
Take medication and inject insulin
Around 425 million adults worldwide suffer from diabetes mellitus. Around 7.6 million people in Germany are diabetic. 95 percent of them have type 2 diabetes. People usually have to take medication or inject insulin, measure blood sugar and pay attention to their diet. However, there is evidence that type 2 diabetes can be cured without medication.
The number of diabetics will continue to increase
As the Deutsche Diabetes Gesellschaft (DDG) reports in a statement, projections from the data of the statutory health insurance suggest an increase in diabetes cases by more than 50 percent within the next 20 years.
Researchers at the German Diabetes Center (DDZ) in Düsseldorf and the Robert Koch Institute (RKI) in Berlin predict that in 2040 up to twelve million people in Germany could be affected by type 2 diabetes.
Already now, twelve percent of health expenditures in Germany are spent on the treatment of the metabolic disorder.
In view of these increasing numbers, experts are discussing measures for diabetes prevention as well as options for remission or even cure internationally.
Reduced calorie diet
"Until recently, type 2 diabetes was seen as a chronically progressive disease that ultimately has to be treated lifelong with medication or insulin due to increasingly failing insulin production," explains Professor Dr. Michael Roden, Congress President of the Diabetes Congress 2019, which will take place in Berlin from May 29 to June 1.
"While insulin therapy for type 1 diabetes is lifelong, there is now increasing evidence that both lifestyle interventions and bariatric surgery can make it possible to dispense with medication for type 2 diabetes."
Results of the DiRECT study published in the specialist magazine "Cell Metabolism" showed that a diet that was significantly reduced in calories using formula foods and the associated significant weight loss could enable remission of type 2 diabetes.
Improvement through weight loss
The British study by scientists from Newcastle University involved 298 overweight patients. Half of the subjects managed to normalize their blood glucose levels again and to avoid medication.
The more they lost weight, the greater the success of the treatment: In patients who lost more than 15 kg, around 85 percent had diabetes remission.
"Study director Professor Roy Taylor from Newcastle-Upon-Tyne University will present his structured weight loss program at the Diabetes Congress," said Professor Roden.
"We will also discuss why after two years only about a third of the participants were still in remission and how cost-effective the program is."
Remission is not synonymous with healing
Another increasingly common strategy is bariatric surgery, the success of which in type 2 diabetes will discuss Professor Francesco Rubino of Kings College London.
According to the information, gastric bypass and sleeve gastrectomy are currently very successful surgical methods by means of which normalization of blood glucose levels can be achieved in those who are very overweight.
With both surgical techniques, the stomach is reduced in size, with gastric bypass a part of the small intestine is also “switched off”.
However, remission is not synonymous with healing.
"Remission is defined as a non-diabetic condition without glucose-lowering medication - this may only be temporary," explains Professor Roden, who is also director of the Clinic for Endocrinology and Diabetology at the University Hospital Düsseldorf.
"The long-term success and above all the prevention or reduction of diabetes-related complications and complications will be decisive for the comparison of the different interventions." (Ad)