- A new study looks at how diabetes remission can impact your heart health.
- If a person is able to be in remission for a long-period of time, the effects on heart and kidney health can be substantial.
- However it can be difficult to maintain diabetes remission through lifestyle changes alone.
New research has revealed that diabetes remission is associated with a lower risk of cardiovascular disease and chronic kidney disease.
The study, published in the journal Diabetologia on Thursday, is one of the first to highlight the impact diabetes remission can have on cardiovascular outcomes.
The trial showed that type 2 diabetes remission is possible through lifestyle interventions —such as exercising and eating healthy — that lead to significant weight loss.
That said, the risk reduction is largely dependent on how long people are able to maintain remission, which can be difficult with diabetes.
It can be difficult to maintain diabetes remission through lifestyle changes alone, but if long-term remission is achieved, the effects on heart and kidney health can be substantial.
“This paper closes the loop by showing that there are interventions that can reverse diabetes and that reversing it can reduce the risk of heart and kidney disease,” Dr. Harlan Krumholz, a professor of medicine (cardiology) at Yale School of Medicine, told Healthline.
Krumholz was not involved in the study.
The post hoc analysis looked at the health data of 5,145 adults who were enrolled in the Look AHEAD study, a trial running from 2001 to 2016 that compared how a 12-year lifestyle intervention impacted rates of heart disease and other chronic conditions versus diabetes education and support.
The participants, all of whom were overweight or had obesity with type 2 diabetes, were divided into two groups.
The participants in the lifestyle intervention group were instructed to make lifestyle changes — including increased physical activity and healthier dietary changes — to achieve long-term weight loss.
They attended weekly group and individual sessions in the first six months, then two group sessions and one individual session for the next six months, two sessions a month for years two to four, followed by monthly support sessions from years four to 12.
The participants receiving diabetes education and support attended three group sessions a year that focused on diet, physical activity, and social support.
They did not receive individualized support.
All of the participants attended an initial clinic visit, then annual follow-up visits for four years, followed by visits every two years for the remaining 12 years.
The researchers identified who had achieved diabetes remission, defined as taking no diabetes medications and having a glycated hemoglobin (HbA1c), a measure of blood sugar control, of <48 mmol/mol (6.5%) at any point during the trial.
They found that those who achieved diabetes remission had a 33% lower rate of chronic kidney disease and a 40% lower rate of cardiovascular disease.
The risk reduction was most pronounced in people with long-term remission.
Those who maintained remission for a minimum of four years had a 55% lower risk of chronic kidney disease and a 49% lower risk of cardiovascular disease.
With diabetes, long-term remission is hard to sustain.
In this trial, 11% of participants in the lifestyle intervention group achieved remission at one year, but only 4% were in remission by the 8th year of the study.
“If one is able to use intensive lifestyle interventions to have the type 2 diabetes go into remission, this can help reduce the risk of chronic kidney disease and cardiovascular disease,” said Dr. Marilyn Tan, a clinical associate professor of medicine at Stanford Medicine.
Tan was not involved in the study
Diabetes and hypertension, or high blood pressure, are the leading causes of
In addition, if you have diabetes you’re twice as likely to have cardiovascular disease, and the longer you have diabetes, the more likely you are to develop heart disease, according to the
“Diabetes is a principal cause of heart and kidney disease by exposing vital organs to higher levels of blood sugar, inciting inflammation and other adverse conditions for the body, and causing harm,” says Krumholz.
The lifestyle changes that contribute to diabetes remission, including weight loss, increased exercise, and a healthier diet, can improve multiple cardiovascular risk factors, like obesity, hypertension, hyperlipidemia, and inflammation, too, says Tan.
“This study showed that people could reverse diabetes by changing their behaviors, and that reveals the power we have over our health,” Krumholz said.
With diabetes remission, even though blood sugar levels may normalized off medications, regaining weight or resuming unhealthy lifestyle habits can lead to the re-development of diabetes.
To sustain remission, it’s important to keep up with the habits that led to remission in the first place.
That said, this can be difficult to do, especially when the remission depends on behaviors, says Krumholz.
Diabetes is multi-factorial, and in addition to diet, weight, and lifestyle, it can be caused by genetics, family history, and other medications such as glucocorticoids and anti-psychotics, according to Tan.
“Sometimes, despite one’s best efforts, diabetes may still progress due to the above mentioned non-modifiable factors,” Tan said.
When it comes to maintaining long-term remission, it’s important to find sustainable diets and habits.
For example, people are less likely to stick with extreme eating plans.
“If the person stops the diet or regains weight, the diabetes can return,” says Tan.
Even though weight loss tends to be better sustained with bariatric surgery, weight regain can still happen, increasing a person’s risk for re-developing diabetes.
Starting with lifestyle changes is reasonable, according to Krumholz, but combining that with other interventions, like surgery and anti-obesity medications, may lead to more durable effects.
“I am hopeful that lifestyle, supplemented as needed by medications or surgery, might be a winning lifelong strategy,” Krumholz said.
New research has revealed that diabetes remission is associated with a lower risk of cardiovascular disease and chronic kidney disease. Type 2 diabetes remission is possible through lifestyle interventions — such as exercising and eating healthy — that lead to significant weight loss. It can be difficult to maintain diabetes remission through lifestyle changes alone, but if long-term remission is achieved, the effects on heart and kidney health can be substantial.