66-OR: Remission of Type 2 Diabetes for Two Years Is Associated with Full Recovery of Beta-Cell Functional Mass in the Diabetes Remission Clinical Trial (DiRECT)

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 66-OR
Author(s):  
SVIATLANA V. ZHYZHNEUSKAYA ◽  
AHMAD AL-MRABEH ◽  
ALISON C. BARNES ◽  
BENJAMIN ARIBISALA ◽  
KIEREN G. HOLLINGSWORTH ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Beta Cell ◽  
Diabetes Remission ◽  
Full Recovery

Diabetes Remission Clinical Trial (DiRECT)—Plasma Liver Function Tests Reflect Change in Liver Fat Content in Early Type 2 Diabetes

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1834-P
Author(s):  
SVIATLANA V. ZHYZHNEUSKAYA ◽  
AHMAD AL-MRABEH ◽  
CARL PETERS ◽  
ALISON C. BARNES ◽  
KIEREN G. HOLLINGSWORTH ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Liver Function ◽  
Liver Function Tests ◽  
Fat Content ◽  
Diabetes Remission ◽  
Liver Fat ◽  
Early Type ◽  
Liver Fat Content

scholarly journals Type 2 diabetes remission 1 year after an intensive lifestyle intervention: A secondary analysis of a randomized clinical trial

2019 ◽  
Vol 21 (10) ◽  
pp. 2257-2266 ◽  
Author(s):  
Mathias Ried‐Larsen ◽  
Mette Y. Johansen ◽  
Christopher S. MacDonald ◽  
Katrine B. Hansen ◽  
Robin Christensen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Lifestyle Intervention ◽  
Secondary Analysis ◽  
Diabetes Remission ◽  
Intensive Lifestyle Intervention ◽  
Type 2 Diabetes Remission

scholarly journals Predictors of type 2 diabetes remission in the Diabetes Remission Clinical Trial (DiRECT)

2020 ◽  
Author(s):  
G. Thom ◽  
C.‐M. Messow ◽  
W. S. Leslie ◽  
A. C. Barnes ◽  
N. Brosnahan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Diabetes Remission ◽  
Type 2 Diabetes Remission

Pathophysiology of Remission in Type 2 Diabetes—The Diabetes Remission Clinical Trial (DiRECT)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 40-OR
Author(s):  
ROY TAYLOR ◽  
AHMAD AL-MRABEH ◽  
SVIATLANA V. ZHYZHNEUSKAYA ◽  
CARL PETERS ◽  
ALISON C. BARNES ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Diabetes Remission

OP272 Two-Year Within-Trial And Estimated Lifetime Cost Effectiveness Of The Weight Management Program In The Diabetes REmission Clinical Trial (DiRECT)

2020 ◽  
Vol 36 (S1) ◽  
pp. 4-4
Author(s):  
Yiqiao Xin ◽  
Andrew Davies ◽  
Andrew Briggs ◽  
Louise McCombie ◽  
C. Martina Messow ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Cost Effectiveness ◽  
Cost Saving ◽  
Lifetime Cost ◽  
Diabetes Remission ◽  
Management Program ◽  
Weight Management Program ◽  
Trial Cost

IntroductionType 2 diabetes results mainly from weight gain in adult life and affects one in twelve people worldwide. In the Diabetes REmission Clinical Trial (DiRECT), the primary care-led Counterweight-Plus weight management program achieved remission of type 2 diabetes (for up to six years) for forty-six percent of patients after one year and thirty-six percent after two years. The objective of this study was to estimate the implementation costs of the program, as well as its two-year within-trial cost effectiveness and lifetime cost effectiveness.MethodsWithin-trial cost effectiveness included the Counterweight-Plus costs (including training, practitioner appointments, and low-energy diet), medications, and all routine healthcare contacts, combined with achieved remission rates. Lifetime cost per quality-adjusted life-year (QALY) was estimated according to projected durations of remissions, assuming continued relapse rates as seen in year two of DiRECT and the consequent life expectancy, quality of life and healthcare costs.ResultsThe two-year intervention cost was EUR 1,580 per participant, with over eighty percent of the costs incurred in year one. Compared with the control group, medication savings were EUR 259 (95% confidence interval [CI]: 166–352) for anti-diabetes drugs and EUR 29 (95% CI: 12–47) for anti-hypertensive medications. The intervention was modeled with a lifetime horizon to achieve a mean 0.06 (95% CI: 0.04–0.09) gain in QALYs for the DiRECT population and a mean total lifetime cost saving per participant of EUR 1,497 (95% CI: 755–2,331), with the intervention becoming cost-saving within six years.ConclusionsThe intensive weight loss and maintenance program reduced the cost of anti-diabetes drugs through improved metabolic control, achieved diabetes remission in over one-third of participants, and reduced total healthcare contacts and costs over two years. A substantial lifetime healthcare cost saving is anticipated from periods of diabetes remission and delaying complications. Healthcare resources could be shifted cost effectively to establish diabetes remission services, using the existing DiRECT intervention, even if remissions are only maintained for limited durations. However, more research investment is needed to further improve weight-loss maintenance and extend remissions.

Probiotic supplementation and [beta]-cell function in type 2 diabetes: evidence from randomized clinical trial

2019 ◽  
Author(s):  
Nazarii Kobyliak ◽  
Galyna Mykhalchyshyn ◽  
Dmytro Kyriienko ◽  
Liudmyla Kononenko ◽  
Iuliia Komisarenko
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Beta Cell ◽  
Randomized Clinical Trial ◽  
Beta Cell Function ◽  
Cell Function ◽  
Probiotic Supplementation

scholarly journals The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2193
Author(s):  
Iris M. de Hoogh ◽  
Johanneke E. Oosterman ◽  
Wilma Otten ◽  
Anne-Margreeth Krijger ◽  
Susanne Berbée-Zadelaar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Beta Cell ◽  
Lifestyle Intervention ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cell Function ◽  
Diabetes Remission ◽  
Underlying Pathophysiology ◽  
Underlying Pathology

Although lifestyle interventions can lead to diabetes remission, it is unclear to what extent type 2 diabetes (T2D) remission alters or improves the underlying pathophysiology of the disease. Here, we assess the effects of a lifestyle intervention on T2D reversal or remission and the effects on the underlying pathology. In a Dutch primary care setting, 15 adults with an average T2D duration of 13.4 years who were (pharmacologically) treated for T2D received a diabetes subtyping (“diabetyping”) lifestyle intervention (DLI) for six months, aiming for T2D remission. T2D subtype was determined based on an OGTT. Insulin and sulphonylurea (SU) derivative treatment could be terminated for all participants. Body weight, waist/hip ratio, triglyceride levels, HbA1c, fasting, and 2h glucose were significantly improved after three and six months of intervention. Remission and reversal were achieved in two and three participants, respectively. Indices of insulin resistance and beta cell capacity improved, but never reached healthy values, resulting in unchanged T2D subtypes. Our study implies that achieving diabetes remission in individuals with a longer T2D duration is possible, but underlying pathology is only minimally affected, possibly due to an impaired beta cell function. Thus, even when T2D remission is achieved, patients need to continue adhering to lifestyle therapy.

Outcomes of metabolic surgery in obese patients with type 2 diabetes with respect to impact on beta cell function, insulin sensitivity and diabetes remission - A study from south India

2020 ◽  
Vol 14 (6) ◽  
pp. 1829-1835
Author(s):  
Sundaramoorthy Chandru ◽  
Thyparambil Aravindakshan Pramodkumar ◽  
Rajendra Pradeepa ◽  
Subramaniapillai Muthukumar ◽  
Muthuswamy Balasubramanyam ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Sensitivity ◽  
Beta Cell ◽  
Metabolic Surgery ◽  
Beta Cell Function ◽  
South India ◽  
Cell Function ◽  
Diabetes Remission ◽  
Obese Patients

scholarly journals Time Course of Normalization of Functional β-Cell Capacity in the Diabetes Remission Clinical Trial After Weight Loss in Type 2 Diabetes

Diabetes Care ◽  
2020 ◽  
Vol 43 (4) ◽  
pp. 813-820 ◽  
Author(s):  
Sviatlana V. Zhyzhneuskaya ◽  
Ahmad Al-Mrabeh ◽  
Carl Peters ◽  
Alison Barnes ◽  
Benjamin Aribisala ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Weight Loss ◽  
Time Course ◽  
Diabetes Remission ◽  
Β Cell ◽  
Cell Capacity
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