T2D Remission Through Weight Loss Linked With Lower Rates of Chronic Kidney, Cardiovascular Disease
A study found that patients with type 2 diabetes who showed evidence of any remission had a 33% lower rate of chronic kidney disease, and a 40% lower rate of the composite cardiovascular disease measure.
Patients with type 2 diabetes who showed evidence of remission through lifestyle interventions had a significantly lower risk of chronic kidney and cardiovascular disease, according to research published in the journal Diabetologia.1
Remission from Type 2 diabetes is known to have many potential benefits for patients, including improved quality of life. While remission through weight loss has usually been associated with bariatric surgery, lifestyle interventions have also been shown to be effective.
“Remission from diabetes after bariatric surgery has been shown to be followed by lower incidences of cardiovascular disease and chronic kidney disease,” the authors wrote. “However, bariatric surgery leads to substantially greater and longer-term normalization of glucose than remission achieved through lifestyle intervention. Despite the growing interest in diabetes remission as a goal through lifestyle intervention, the long-term impact of achieving this goal remains unclear.”
Investigators from RCSI University of Medicine and Health Sciences in Dublin, Ireland conducted a study to examine the association of diabetes remission in the context of a 12-year intensive lifestyle intervention with subsequent incidence of chronic kidney disease and cardiovascular disease. Data was gathered from the Look AHEAD study (NCT00017953), a clinical trial assessing the long-term effects of a lifestyle intervention designed to achieve and maintain weight loss in patients with type 2 diabetes.
The Look AHEAD study included 5145 adults with overweight or obesity and type 2 diabetes. The intervention included attending weekly group and individual support sessions for 12 years. The sessions were used to offer participants advice on diet, physical activity, and social support. The aim of the interventions were to reduce total caloric intake, total fat and saturated fat intake, and increase levels of physical activity.
Investigators found that, compared to participants who did not achieve remission, those who showed evidence of any remission had a 33% lower rate of chronic kidney disease, and a 40% lower rate of the composite cardiovascular disease measure. Analyses were adjusted for HbA1C, blood pressure, lipid levels, cardiovascular disease history, and diabetes duration.
Participants who had a short duration of diabetes, low starting HbA1C, and a larger amount of weight loss were the most likely to experience remission. Additionally, patients with evidence of longer-term remission had the greatest risk reduction.
The authors noted that remission from type 2 diabetes may be associated with lower rates of chronic kidney disease and cardiovascular disease through several pathways, including sustained reduction in HbA1C, and physiological effects of extensive weight loss like reductions in blood pressure, insulin resistance, and inflammation.
“Using lessons learned from this study we can help inform diabetes treatment methods and improve quality of life for people with type 2 diabetes,” Edward Gregg, lead author on the study, said in a release.2 “It has highlighted the significance of weight loss for achieving remission from type 2 diabetes and then long-term positive cardiovascular and kidney disease outcomes”
