Evidence for rebooting beta cells with weight loss in T2D

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Eddy Edson

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Relationship to Diabetes
Type 2
A study offshoot from the DiRECT 2-year follow up, supporting the hypothesis that clearing fat from the pancreas can allow beta cells to reboot, in T2D.

https://care.diabetesjournals.org/content/early/2020/01/22/dc19-0371

RESULTS During remission, median (interquartile range) maximal rate of insulin secretion increased from 581 (480–811) pmol/min/m2 at baseline to 736 (542–998) pmol/min/m2 at 5 months, 942 (565–1,240) pmol/min/m2 at 12 months (P = 0.028 from baseline), and 936 (635–1,435) pmol/min/m2 at 24 months (P = 0.023 from baseline; n = 20 of 39 of those initially in remission). This was comparable to the NDC [nondiabetic control] group (1,016 [857–1,507] pmol/min/m2) by 12 (P = 0.064) and 24 (P = 0.244) months. Median first-phase insulin response increased from baseline to 5 months (42 [4–67] to 107 [59–163] pmol/min/m2; P < 0.0001) and then remained stable at 12 and 24 months (110 [59–201] and 125 [65–166] pmol/min/m2, respectively; P < 0.0001 vs. baseline) but lower than that of the NDC group (250 [226–429] pmol/min/m2; P < 0.0001).

CONCLUSIONS A gradual increase in assessed functional β-cell capacity occurred after weight loss, becoming similar to NDC participants by 12 months. This was unchanged at 2 years with continuing remission of type 2 diabetes.
 
It’s nothing to do with a “reboot” of the beta cells, it’s just clearing the way for the insulin hormone to escape. Common sense. Like taking the wrapping off a pack of custard creams.
 
It’s nothing to do with a “reboot” of the beta cells, it’s just clearing the way for the insulin hormone to escape. Common sense. Like taking the wrapping off a pack of custard creams.

Well, the papers refer to it as loss & regain of beta cell "specialised function".

It appears to enter a survival mode in which its specialised functions are shut down. Removal of the fat allows re-expression of the insulin gene and resumption of acute glucose-mediated insulin secretion

I'm sticking with "re-boot" 🙂
 
If there weren't so many numbers involved I would feel less intimidated by diabetes!😉
 
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