A recent study published in The BMJ has found that a combination of the drug dapagliflozin and moderate calorie restriction significantly increases remission rates for adults with type 2 diabetes, compared to calorie restriction alone.
This discovery offers hope for a practical approach to managing and potentially reversing this condition for some patients.
Type 2 diabetes is a global health challenge affecting more than 400 million adults. While it is often seen as a lifelong disease, it can sometimes be reversed through significant weight loss. However, the most effective methods, such as very low-calorie diets or bariatric surgery, can be difficult to follow or access.
Medications like SGLT-2 inhibitors, including dapagliflozin, are known to lower blood sugar levels and promote weight loss, but their ability to assist in diabetes remission when combined with dietary changes has not been well studied—until now.
To explore this, researchers conducted a study involving 328 adults with type 2 diabetes diagnosed within the past six years. The trial took place at 16 centers across mainland China between June 2020 and January 2023. P
articipants were between the ages of 20 and 70, had a body mass index (BMI) over 25, and were only taking metformin as a diabetes treatment.
People with certain medical conditions, a history of stomach surgery, or who were taking weight loss drugs were excluded.
Participants were randomly divided into two groups: one group followed a moderate calorie restriction diet (reducing daily intake by 500–750 calories) combined with daily dapagliflozin (10 mg), while the other group followed the same diet paired with a placebo. The trial lasted 12 months.
All participants received dietary counseling, maintained food logs, and were encouraged to stay active, either through brisk walking for 150 minutes a week or achieving at least 10,000 steps daily. Diabetes remission was defined as maintaining normal blood sugar levels for at least two months without the use of diabetes medications.
At the end of the study, 44% of those in the dapagliflozin group achieved remission, compared to 28% in the placebo group. The dapagliflozin group also experienced greater weight loss and improved insulin sensitivity.
Additional benefits included reductions in body fat, systolic blood pressure, and cholesterol levels. Importantly, no significant differences in side effects were observed between the two groups.
The researchers acknowledged some limitations of the study. For example, the results may not apply to people who have had diabetes for longer than six years or to individuals from different ethnic backgrounds. The study also did not measure total energy expenditure, which might have provided more insight into participants’ physical activity levels.
Despite these limitations, the study demonstrated that combining dapagliflozin with a manageable calorie restriction plan is both feasible and effective in a clinical setting. Most participants adhered well to the program, and further analyses confirmed the robustness of the results.
The findings highlight the potential for a combined approach to diabetes remission that is less invasive than surgery or extreme dieting.
However, questions remain. For instance, should medications like dapagliflozin be stopped once remission is achieved? Could the drug’s mechanisms be tailored to individual patients for even better outcomes?
These uncertainties suggest the need for further research. In the meantime, SGLT-2 inhibitors, already a first-line treatment for type 2 diabetes alongside metformin, appear to be an important part of combined strategies for managing and reversing the condition.
In conclusion, this study offers a promising new option for people with early type 2 diabetes who are overweight or obese. It reinforces the value of integrating medication with sustainable lifestyle changes to improve long-term health outcomes.
While more research is needed, this combined approach may help many patients achieve better control over their diabetes and, in some cases, remission.
If you care about diabetes, please read studies about diabetes and vitamin B12, and the right diet for people with type 2 diabetes.
For more health information, please see recent studies about how to eat smart with diabetes, and turmeric and vitamin D: a duo for blood pressure control in diabetic patients.
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