Many doctors and patients do not realize that weight loss can reverse type 2 diabetes. Instead, there is a widespread belief that the disease is “progressive and incurable,” according to a new report published in the BMJ.
This is despite there being “consistent evidence” that shedding around 33 pounds (15 kilograms) often produces “total remission” of type 2 diabetes, note Prof. Mike E. J. Lean and other researchers from the University of Glasgow in the United Kingdom.
The thrust of their paper is that greater awareness, when combined with better recording and monitoring of remissions, could result in many more patients no longer having to live with type 2 diabetes and a massive reduction in healthcare costs.
The global burden of type 2 diabetes has nearly quadrupled over the past 35 years. In 1980, there were around 108 million people with the disease, and by 2014, this number had risen to 422 million.
The vast majority of diabetes cases are type 2 diabetes, which is a disease that results when the body becomes less effective at using insulin to help cells to convert blood sugar, or glucose, into energy. Excess body weight is a main cause of this type of diabetes.
In the United States, an estimated 30.3 million people, or around 9.4 percent of the population, have diabetes – including around 7.2 million who do not realize it.
Diabetes accounts for a high portion of the national bill for taking care of the sick. The total direct and indirect cost of diagnosed diabetes in the U.S. was estimated to be $245 billion in 2012.
In that year, of the $13,700 average medical spend for people with diagnosed diabetes, more than half (around $7,900) was directly attributed to the disease.
Prof. Lean and colleagues note that the current management guidelines for type 2 diabetes focus on reducing blood sugar levels and cardiovascular risks primarily through the “use of antidiabetes drugs, with only lip service paid to diet and lifestyle advice.”
The result is that many patients develop further health problems and live, on average, 6 years less than people who do not have diabetes.
In the meantime, while remission of the disease “is clearly attainable for some, possibly many, patients,” the authors note that currently, it is “very rarely achieved or recorded.”
For example, they highlight a U.S. study that followed 120,000 patients over 7 years and found that only 0.14 percent of them were recorded as remissions.
Another example is that of the Scottish Care Information database, which holds records for every patient in Scotland. It shows that only 0.1 percent of type 2 diabetes patients are coded as being in remission.
Part of the problem, argue the study authors, is that clinicians hesitate to code patients as being in remission because of a lack of agreed criteria and guidance.
However, they suggest that the main likely cause of low remission recording in type 2 diabetes is that few patients are actually trying to achieve it.
They urge health authorities worldwide to agree clearer guidelines about how to measure type 2 diabetes remission and make sure that it is officially recorded.
“Appropriate coding,” they note, “will make it possible to monitor progress in achieving remission of type 2 diabetes nationally and internationally and to improve predictions of long-term health outcomes for patients with a known duration of remission.”
Better coding could also raise awareness and result in more people trying to reverse the condition, such as by losing weight, rather than accepting that they have to live with it.
Not only are there clear health benefits to reversing type 2 diabetes, but it can also give people a sense of achievement and empowerment.
In addition, it removes the stigma of being labeled “diabetic” and may even result in lower premiums for health insurance, travel insurance, and mortgages.
“Recognizing and accurately coding reversal of type 2 diabetes is key to improving outcomes and reducing healthcare costs.”