Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for beta cell recovery

Taylor, R., Al-Mrabeh, A., Zhyzhneuskaya, S., Peters, C., Barnes, A. C., Aribisala, B. S., Hollingsworth, K. G., Mathers, J., Sattar, N. and Lean, M. E.J. (2018) Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for beta cell recovery. Cell Metabolism, 28, pp. 1-10. (doi: 10.1016/j.cmet.2018.07.003) (PMID:30078554)

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Abstract

The Diabetes Remission Clinical Trial reported return and persistence of non-diabetic blood glucose control in 46% of people with type 2 diabetes of up to 6 years duration. Detailed metabolic studies were performed on a subgroup (intervention, n = 64; control, n = 26). In the intervention group, liver fat content decreased (16.0% ± 1.3% to 3.1% ± 0.5%, p < 0.0001) immediately after weight loss. Similarly, plasma triglyceride and pancreas fat content decreased whether or not glucose control normalized. Recovery of first-phase insulin response (0.04[−0.05–0.32] to 0.11[0.0005–0.51] nmol/min/m2, p < 0.0001) defined those who returned to non-diabetic glucose control and this was durable at 12 months (0.11[0.005–0.81] nmol/min/m2, p = 0.0001). Responders were similar to non-responders at baseline but had shorter diabetes duration (2.7 ± 0.3 versus 3.8 ± 0.4 years; p = 0.02). This study demonstrates that β cell ability to recover long-term function persists after diagnosis, changing the previous paradigm of irreversible loss of β cell function in type 2 diabetes.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lean, Professor Michael and Sattar, Professor Naveed
Authors: Taylor, R., Al-Mrabeh, A., Zhyzhneuskaya, S., Peters, C., Barnes, A. C., Aribisala, B. S., Hollingsworth, K. G., Mathers, J., Sattar, N., and Lean, M. E.J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Cell Metabolism
Publisher:Elsevier (Cell Press)
ISSN:1550-4131
ISSN (Online):1932-7420
Published Online:02 August 2018
Copyright Holders:Copyright © 2018 Elsevier
First Published:First published in Cell Metabolism 28:1-10

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
614611Reversal of T2DM to normal glucose tolerance using non-surgical weight management with low-energy liquid- diet and long-term maintenance, within routine NHS care: study extensionMichael LeanDiabetes UK (DIABETUK)13/0004691MVLS MED -HUMAN NUTRITION