A recent clinical trial published in The BMJ indicates that a combination of calorie restriction and the diabetes drug dapagliflozin can reverse type 2 diabetes in a significant portion of patients. The study, conducted with over 300 adults in China, highlights a potentially more accessible and practical approach to managing this widespread condition.
The trial focused on individuals diagnosed with type 2 diabetes within the past six years. Participants were randomly assigned to either a dapagliflozin group or a placebo group, while both groups adhered to a calorie-restricted diet and physical activity routine. The calorie restriction involved reducing daily intake by 500 to 750 calories, combined with regular physical activity such as 150 minutes of brisk walking per week or exceeding 10,000 steps daily.
Key Findings
The results demonstrated a notable difference in remission rates between the two groups. In the dapagliflozin group, 44% of participants achieved remission, defined as maintaining normal blood sugar levels for at least two months after discontinuing diabetic medication. In contrast, only 28% of participants in the placebo group achieved remission.
Furthermore, the dapagliflozin group experienced an average weight loss of 11 pounds, compared to 7 pounds in the placebo group. These patients also showed improved insulin sensitivity, lower cholesterol levels, and better blood pressure readings.
Mechanism of Action and Expert Commentary
Dapagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, regulates blood sugar by promoting glucose excretion through urine, thereby reducing reliance on insulin. Dr. Xiaoying Li, the study’s lead researcher, stated, "This study provides a practical strategy to achieve remission for patients with type 2 diabetes."
An editorial accompanying the study emphasized the significance of combining less intense calorie restriction with SGLT2 inhibitors, noting that "achieving remission through less intense calorie restriction may prove more inclusive at the population level."
Implications for Diabetes Care
These findings suggest that integrating healthy lifestyle changes with medical treatments like dapagliflozin could be a viable path toward remission for individuals managing type 2 diabetes. The combination of moderate calorie restriction, regular physical activity, and appropriate medication may offer a more sustainable and accessible approach compared to more drastic interventions.
While the study's results are promising, researchers noted that the findings might not be generalizable to all type 2 diabetes patients, particularly those of other races or those who have had the disease for more than six years. Further research is needed to explore the long-term effects and broader applicability of this combined treatment strategy.
