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Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent upon Capacity for β Cell Recovery

Lookup NU author(s): Professor Roy Taylor, Dr Ahmad Al-Mrabeh, Dr Sviatlana Zhyzhneuskaya, Dr Carl Peters, Ali/Alison BarnesORCiD, Dr Benjamin Aribisala, Dr Kieren HollingsworthORCiD, Professor John MathersORCiD

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).

Abstract

Copyright © 2018 Elsevier Inc. All rights reserved. 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.

Publication metadata

Author(s): Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, Peters C, Barnes AC, Aribisala BS, Hollingsworth KG, Mathers JC, Sattar N, Lean MEJ

Publication type: Article

Publication status: Published

Journal: Cell Metabolism

Year: 2018

Volume: 28

Issue: 4

Pages: 547-556

Print publication date: 02/10/2018

Online publication date: 02/08/2018

Acceptance date: 06/07/2018

Date deposited: 21/12/2018

ISSN (print): 1550-4131

ISSN (electronic): 1932-7420

Publisher: Cell Press

URL: https://doi.org/10.1016/j.cmet.2018.07.003

DOI: 10.1016/j.cmet.2018.07.003

PubMed id: 30078554

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