Journal Club - Weight loss programme to be effective in managing diabetes: DIRECT TRIAL

A recent UK study has shown that a weight loss program can lead to type 2 diabetes remission, even in individuals with a normal body mass index (BMI). This is achieved via loss of body fat, particularly in the liver and pancreas.

The ReTUNE trial that is Reversal of Type 2 Diabetes Upon Normalisation of Energy Intake in Non-obese People, involved 20 people with type 2 diabetes of less than 6 year's duration and a BMI of 27 kg/m2 or lower. After 1 year, participants had lost 9% of their body weight. Their body fat decreased significantly, to the same level as controls without type 2 diabetes, and they experienced decreases in liver fat, total triglycerides, and pancreatic fat.

These findings support the theory of a personal fat threshold, above which "type 2 diabetes occurs," and "Weight loss is the first-line treatment for all with type 2 diabetes, irrespective of BMI." On the other hand, the  DiRECT trial showed that a calorie-restricted liquid diet followed by gradual food reintroduction and a weight loss maintenance program can achieve and sustain type 2 diabetes remission at 2 years in people who are overweight or obese.