Weight loss is among the ‘best routes to diabetes remission’

Weight loss is among the ‘best routes to diabetes remission’

Context:

Advancements in hypoglycemic drugs, bariatric surgery, reduced caloric intake, use of intestinal hormones, and weight-reducing drugs have made the possibility of diabetes remission more feasible.

Relevance:
GS-02 (Health)

Key Highlights:

  1. Understanding Diabetes Remission: According to the American Diabetes Association, diabetes remission is defined as the normalization of glycated hemoglobin (HbA1c under 6.5%) for at least three months after stopping glucose-lowering drugs. It is important to note that remission is not a cure but a state where the disease is not actively progressing.
  2. Weight Loss: Weight loss is one of the most effective methods for achieving diabetes remission. The DiRECT study showed that about 46% of type 2 diabetes patients reached remission in 12 months with a structured weight management program, particularly those who lost over 10 to 15 kg.
  3. Bariatric Surgery: Bariatric surgery has been found beneficial for T2DM patients with a BMI less than 35 kg/m², with a remission rate of 56.6%. This surgical intervention aids in achieving better glycemic control and remission.
  4. Lifestyle Interventions: Dietary changes, such as low-calorie and low-carbohydrate diets, have shown effective weight loss leading to diabetes remission by reducing fat in the liver and pancreas.
  5. Medical Interventions: New hypoglycemic drugs like GLP1-RA and tirzepatide (a dual agonist of GLP1 and GIP) have shown efficiency in diabetes remission by aiding in significant weight reduction and better glycemic control.
  6. Continuous Monitoring: Diabetes remission requires continuous monitoring, as the risk of recurrence remains high. Regular testing of HbA1c or other glycemic control measures should be performed annually to ensure sustained remission.

Understanding Glycemic Index and Glycemic Load:

  • Glycemic Index (GI):
    • The concept of GI was introduced by Prof. David Jenkins. It assesses how foods affect blood glucose levels.
    • It categorizes foods into low, medium, and high GI based on their impact compared to glucose.
    • Foods with higher GI values lead to elevated blood sugar readings.
    • The scale ranges from 0 to 100, with pure glucose assigned a value of 100.
    • Lower GI foods cause a slower increase in blood sugar levels, while highly processed foods tend to have higher GI values. Additionally, foods rich in fiber or fat typically have lower GI values.
  • Glycemic Load:
    • Glycemic Load (GL) considers both the quality and quantity of carbohydrates in a specific food.
    • It is determined by multiplying the food’s GI by the amount of available carbohydrate in a serving.

Key Facts about Diabetes:

  • Diabetes is a chronic condition characterized by either the pancreas’s inability to produce insulin or the body’s ineffective use of the insulin it produces.
  • Insulin is essential for regulating blood glucose levels.
  • Failure to produce or utilize insulin properly results in high blood glucose levels, known as hyperglycemia.
  • Prolonged hyperglycemia can lead to damage to various organs and tissues in the body.

Types of Diabetes:

  • Type 1 Diabetes: In this condition, the immune system attacks and destroys insulin-producing cells (beta cells) in the pancreas. As a result, the body produces little to no insulin. Type 1 diabetes typically requires daily insulin administration to manage blood glucose levels and is often diagnosed in children and young adults.
  • Type 2 Diabetes: Type 2 diabetes arises from the body’s ineffective use of the insulin it produces, often linked to factors such as excess body weight and physical inactivity. Unlike Type 1 diabetes, the pancreas still produces insulin, but the body cannot utilize it effectively.