Type 2 diabetes can be reversed, say Canadian researchers

CTV News Channel: Sending diabetes into remission Endocrinologist Dr. Hertzel Gerstein discusses 'metabolic intervention' an how it can help potentially reverse Type 2 Diabetes.

Adult-onset, or Type 2, diabetes has long been considered a chronic disease that lasts a lifetime, but Canadian researchers believe they may have found a way to actually reverse the disease, putting it into remission.

“We used to think that diabetes is irreversible and a progressive disease,” study author Natalia McInnes told CTV News Channel. “This new research suggests that it’s possible to reverse it.”

The research team, from McMaster University in Hamilton, Ont., says an aggressive combination of a low-calorie diet, consistent exercise and the addition of several diabetes medications appears to have reversed the disease in some patients.

Type 2 diabetes is diagnosed when an individual's body is no longer able to properly use insulin -- the hormone that allows cells to absorb glucose in the blood. As a result, blood sugars build up and cells do not receive the energy they need.

To test whether the condition can be reversed, researchers first studied 83 patients with Type 2 diabetes and broke them into three groups.

Two of the groups received an intensive “metabolic intervention” in which they were provided with a personalized exercise plan, and a meal plan that reduced their daily calorie intake by 500 to 750 calories a day.

They also received the oral diabetes medications metformin and acarbose to tightly manage their blood glucose levels, as well as insulin injections at bedtime to give their pancreases a rest to allow them to recuperate.

One group underwent the program for eight weeks, while the other was treated intensively for sixteen weeks. They were then compared to a third, control group, who received standard blood sugar management advice and lifestyle advice from their usual healthcare provider.

Three months later, 11 out of 27 participants in the 16-week program group met the criteria for complete or partial diabetes remission. Those in the eight-week program didn’t fare as well; only six out of 28 participants in that group met the same criteria. But they still fared better than the third group: among those 28 participants, only four were able to put their diabetes into remission.

The full results of the study appear in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Fifty-year-old John Almeida was diagnosed almost three years ago with Type 2 diabetes and told he'd be on drugs for life. While on the intensive program, he lost 13 pounds and dramatically increased his exercise level. A month ago, researchers told him he could come off the study medications.

A month later blood tests confirm he is in remission, with his pancreas doing all the work. He no longer needs diabetes medication and his blood glucose is in a normal range.

“I did it all. I exercise, I eat right and it's worked,” he says, smiling.

The study’s lead researcher, Dr. Hertzel Gerstein, an endocrinologist at Hamilton Health Sciences, says the goal of the regimen is to get patients to work intensively on weight loss and fitness for a short period so that they can get off medications for good.

“I think as physicians, that is far more preferable than taking drugs for years and years and years,” he said.

Many physicians already advise their diabetic patients to adopt healthier eating and fitness habits. Gerstein says his approach is different in that it adds the medications, uses lifestyle coaches, and is much more intensive.

“What is unique here is we put together all the things that we think might work into one package,” he told CTV News Channel.

With one in 10 Canadian adults currently living with diabetes and the numbers on the rise, he says it’s time to try novel approaches that can put the disease into remission “even if it’s just for six months or a year or two years.”

He added the intensive treatment may not need to be performed just once; it may require courses of treatment every few years to keep the disease in remission.

After their initial success, the research team has started a larger study with 450 patients in eight Canadian cities, to see how long remission can last, and to determine at what stage in the disease patients respond best.

Dr. Gerstein is convinced his team is onto something with this approach.

"There is smoke here that we need to keep going and that is the exciting part of it,” he said.

Those interested in learning if they can participate in the study can email the research team at [e-mail]  The next phase of their study should be complete in 2018.

With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip