Quite cheery news

[Deleted member 21371]

Weight loss can put type 2 diabetes into remission for at least 5 years, DiRECT study reveals

UPDATE, 26 FEBRUARY, 2024: This article has been updated following new findings into our landmark DiRECT study which have been published in the Lancet. Results from a three-year extension of our landmark DIRECT study reveal that for some it’s possible to stay in remission of type 2 diabetes for...

www.diabetes.org.uk

 

[Eddy Edson]

So actually 11 / 98 = about 11% in remission at 5 years.

As with the 2 year result, the main thing determining this would have been how successful individuals have been at maintaining weight loss. The average weight loss from base line for these 11 in-remission folks at the 5 year mark was 8.9kg, down from the ~15kg for those in remission at 2 years.

It's not bad but it's not stellar and for me it just once again demonstrates how difficult it is for many, many people to maintain weight loss, even if it means losing T2D remission. Plenty of people can - eg me, you - but basically we're lucky. Others need more help.

 

[Amity Island]

It is doable (losing weight). It as also doable (not gaining weight).

The reason it is so difficult to lose weight and keep it off is that once the fat cells are established they are there for life.

Thus, as easy is it is to say, better to not gain the weight in the first place. With the endless supply of cheap processed food, preventing weight gain is probably harder now than it ever was.

 

[Deleted member 21371]

So actually 11 / 98 = about 11% in remission at 5 years.

As with the 2 year result, the main thing determining this would have been how successful individuals have been at maintaining weight loss. The average weight loss from base line for these 11 in-remission folks at the 5 year mark was 8.9kg, down from the ~15kg for those in remission at 2 years.

It's not bad but it's not stellar and for me it just once again demonstrates how difficult it is for many, many people to maintain weight loss, even if it means losing T2D remission. Plenty of people can - eg me, you - but basically we're lucky. Others need more help.

11% of 5 million or so isn't a bad number.
Couple that will the new drugs like semaglutide and it should look even better.

 

[bulkbiker]

So actually 11 / 98 = about 11% in remission at 5 years.

And as we know "in remission" in DiRECT's definition can mean pre-diabetic so....

And that 77% of people in remission at 2 years were no longer in remission at 5 years which is rather sad as at 2 years is was only 36% of the total anyway.

As many of us know crash diets aren't effective for long term weight loss and it would now seem long term remission either.

 

[Deleted member 21371]

And as we know "in remission" in DiRECT's definition can mean pre-diabetic so....

And that 77% of people in remission at 2 years were no longer in remission at 5 years which is rather sad as at 2 years is was only 36% of the total anyway.

As many of us know crash diets aren't effective for long term weight loss and it would now seem long term remission either.

550,000 people would disagree.
I'll take being one of them when I ate my Big Mac and fries this morning.

 

[bulkbiker]

550,000 people would disagree.
I'll take being one of them when I ate my Big Mac and fries this morning.

You're assuming that no-one of the 5 million is already in remission.. they would still be counted in that figure.
You and I both are still T2 diabetics to the NHS however we may view ourselves.

 

[Deleted member 21371]

You're assuming that no-one of the 5 million is already in remission.. they would still be counted in that figure.
You and I both are still T2 diabetics to the NHS however we may view ourselves.

Not really fussed on numbers games.
One less diabetic is good news to me.
Half a million is better news.
Your way works for you, so call it half a million and one, and we can all take the win 🙂

 

[Eddy Edson]

It really looks like kind of like any other fairly-intensive intervention program at the 5 year point - not terrible, not great. Weight Watchers gets about the same kind of result,a according to their clinical trials. Virta press releases (no l/term clinical trials) also look about the same https://forum.diabetes.org.uk/board...aybe-about-as-good-as-weight-watchers.100474/

Most people will need meds to maintain the weight loss.

 

[Spathiphyllum]

Most people will need meds to maintain the weight loss.

Funny thing-- 50 years ago people didn't need meds to maintain a healthy weight; and Type 2 was rare.

We have created a society that has created a Type 2 epidemic. If we had the right food policy, transport policy, and planning policy, we could end this epidemic; and the same policies could simultaneously help combat the climate emergency, and improve biodiversity.

 

[Deleted member 21371]

Funny thing-- 50 years ago people didn't need meds to maintain a healthy weight; and Type 2 was rare.

We have created a society that has created a Type 2 epidemic. If we had the right food policy, transport policy, and planning policy, we could end this epidemic; and the same policies could simultaneously help combat the climate emergency, and improve biodiversity.

Make people walk.
I did as a kid

 

[Bruce Stephens]

Make people walk.
I did as a kid

So did I, but there's way more traffic now so that's not risk free.

 

[Deleted member 21371]

So did I, but there's way more traffic now so that's not risk free.

Nothing in life is.

 

[Transistor]

Make people walk.
I did as a kid

How did you make people walk? 😛

 

[nonethewiser]

Funny thing-- 50 years ago people didn't need meds to maintain a healthy weight; and Type 2 was rare.

Or did type 2 mainly go undiagnosed then?

We have created a society that has created a Type 2 epidemic. If we had the right food policy, transport policy, and planning policy, we could end this epidemic; and the same policies could simultaneously help combat the climate emergency, and improve biodiversity.

We had good discussion about this week or 2 back about how our lives are different now to decades before, consensus was we are less active now than before in work & didn't have as many cars then so it was shanks pony to get to work & school.

Big difference also is how we eat, people cook less at home & rely more on convenience food, not everyone but it has got worse given amount of fast food outlets, cafes restaurants in our high streets.

 

[harbottle]

Everyone I know who loses weight gains it again because they go back to eating the same diet that made them overweight. Once you've lost weight you don't need as much energy, but it seems the body tries to get you to go back to the bad ways and it takes will power to overcome the scream for calories that you don't need.

Every day this week the office I work has been piled high with cakes & biscuits. (The next person who tells me to 'have a treat' will get hit around the head with a blunt object.)

The worse offender for eating this junk is someone who showed me that their hba1c was 47 and they'd been told to change lifestyle to stop it from progressing.

 

[Spathiphyllum]

Or did type 2 mainly go undiagnosed then?

I doubt it. I was looking into the history of diabetes a while back, out of curiosity regarding when we adopted the terms 'Type 1' and 'Type 2'. This terminology is actually quite recent-- adopted as the norm I think in the early 1990s?

But, even before the invention of any type of testing strips (let alone the invention of the HbA1c test), it was easy to diagnose diabetes: sugar in the urine. The doctor-- or, if he was lucky enough to have a student, his student-- would taste it ...

And the difference between what we now call Type 1 and Type 2 has also always been easy to recognise. Before insulin was discovered and used as treatment, Type 1 was invariably fatal and fairly quickly-- with little or no insulin, you literally starve to death no matter how much you eat. Significant unintentional weight loss is still a key clinical diagnostic criterion for Type 1.

What we now call Type 2s were easily identifiable as those diabetics who did not suffer from unintentional weight loss but did develop the classic complications of diabetes: poor wound healing, diabetic neuropathy, diabetic retinopathy, etc.

We had good discussion about this week or 2 back about how our lives are different now to decades before, consensus was we are less active now than before in work & didn't have as many cars then so it was shanks pony to get to work & school.

Big difference also is how we eat, people cook less at home & rely more on convenience food, not everyone but it has got worse given amount of fast food outlets, cafes restaurants in our high streets.

Indeed.

Transistor asked "How did you make people walk?" Easy:

50 years ago, more people lived in environments that encouraged and facilitated walking-- to school, to shops, to work, to your local train station or tram stop-- and far fewer people had cars.

But then, for 50 years, we've had policies which have actively encouraged car use and made it much easier and more convenient than walking or cycling or taking public transport. In fact we've had policies which, for many people in many parts of the country, have made it practically impossible not to use a car.

What we need-- for the sake of people's physical and mental health, and for the sake of the environment-- is to reverse this, asap. Walking and cycling and public transport need to be made much easier and more convenient than using a car.

This is not rocket science; we've done it before, and we can do it again.

 

[everydayupsanddowns]

50 years ago, more people lived in environments that encouraged and facilitated walking-- to school, to shops, to work, to your local train station or tram stop-- and far fewer people had cars.

But then, for 50 years, we've had policies which have actively encouraged car use and made it much easier and more convenient than walking or cycling or taking public transport. In fact we've had policies which, for many people in many parts of the country, have made it practically impossible not to use a car.

What we need-- for the sake of people's physical and mental health, and for the sake of the environment-- is to reverse this, asap. Walking and cycling and public transport need to be made much easier and more convenient than using a car.

Was watching the outpouring of rage in news articles this week about 'low traffic neighbourhoods', public policy and planning decisions aiming to reduce traffic flow in some areas to make walking/cycling and even (heaven forbid!) children playing out in the street more enjoyable, safer and in a less polluted atmosphere.

And conspiracists are already whirling around any suggestions that you make it possible, by planning, for people to have most of what they need within 15 minutes from their home.

The addiction to cars will be a tough nut to crack I fear.

 

[Spathiphyllum]

Was watching the outpouring of rage in news articles this week about 'low traffic neighbourhoods', public policy and planning decisions aiming to reduce traffic flow in some areas to make walking/cycling and even (heaven forbid!) children playing out in the street more enjoyable, safer and in a less polluted atmosphere.

And conspiracists are already whirling around any suggestions that you make it possible, by planning, for people to have most of what they need within 15 minutes from their home.

The addiction to cars will be a tough nut to crack I fear.

All this conspiracist stuff about 'the 15-minute city' is horrifying and bizarre. (And, I gather, largely driven by far-right groups in the US and UK; see e.g. https://www.bloomberg.com/news/arti...city-get-tangled-up-in-a-far-right-conspiracy )

I mean-- I think the majority of people in the UK would say that their ideal would be to live either in a) a village with lots of green spaces around and a good local school and good local GP and good local shops, and a nice little well-connected train station, or b) a city neighbourhood with nice parks and quiet tree-lined streets and good neighbourhood schools and good neighbourhood GPs/shops and a nice well-connected Tube or tram or train station. And the proof is in the pricing: places like that are very expensive to buy or rent a home in.

That *is* what the 15-minute city means!

Reasonable people need to make their/our voices heard. I don't believe that most car owners are 'addicted' to cars; I think even most car owners would rather not *have* to use their cars as much as they do. Politicians, of all parties, should not be left with the impression that those currently shouting the loudest represent anywhere near a majority.

 

[harbottle]

The UK has made a huge mistake by moving everything 'out of town' to such an extent that you have to drive everywhere. The city I live in certainly a 'donut city' and the post-war planning managed to make walking into the centre utterly unappealing.