Health chats with Dr.Leeds|Diabetes remission in South Asians Prof Naveed Sattar, University of Glasgow
In this interview Professor Naveed Sattar describes the trial in which people of South Asian ethnicity followed a structured weight loss program based initially on an 850kcal/d formula food diet for 3 to 5 months to determine whether this was acceptable and whether the participants would achieve type 2 diabetes remission, compared to a group following usual care. About one third of those following the weight loss program achieved more than 10% body weight and 43% achieved diabetes remission. Weight loss in the usual care group was around 1kg compared to 7kg in the structured program with formula diet and none of the usual care group achieved diabetes remission. The study provided proof-of-concept and evidence of feasibility and Prof Sattar describes the next steps that are indicated following this work. He makes a plea for observational studies of diabetes remission to be done in multiple centers in the countries of South Asia.
This work follows earlier work undertaken in Glasgow in Scotland and Newcastle in England that showed that diabetes remission is possible in a high proportion of people with type 2 diabetes who lost sufficient weight and maintained that loss. Prof Mike Lean discussed this work in episodes 1 and 2 of this series.
Prof Sattar then outlined his concerns about how global medicine focuses on treating chronic conditions for many of which there is evidence that improvement or even prevention is possible with weight loss. The drift upwards in average population weight by more than 10kg over several decades has resulted in a high proportion of older people having one or more obesity related problems such as diabetes and cardiovascular disease, both of which have been effectively addressed with medications at the time of presentation. He suggests that more emphasis should be given to earlier identification of at-risk individuals and effective weight management to slow progression towards prediabetes and diabetes and slow progression of cardiovascular disease.
In the course of conversation Dr Leeds referred to an art-work ‘Cradle to Grave’ by Pharmacopoeia, that illustrated the typical pattern of usage of medications throughout life of a man and woman living in Britain. It demonstrates very clearly the extensive use of medications in the last few years of life.
Prof Sattar will give the Banting Memorial Lecture ‘Type 2 diabetes management: Weighing up the options’ at the Diabetes UK Conference on April 26th 2023 in Liverpool, England.
Web-links to useful sources of information are given below.
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About Diabetes:
Diabetes remission:
Research-spotlight-low-calorie-liquid-diet
Publications describing results of DiRECT trial:
Dietary weight-management for type 2 diabetes remissions in South Asians:
Viewpoint: Treating chronic diseases without tackling excess adiposity
Artwork: ‘Cradle to Grave’ at British Museum, London, UK
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Diabetes prevention:
The Canadian Diabetes Risk calculator:
The Indian Diabetes risk score:
UK Type 2 diabetes – know your risk
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