Thread by @IndigenousX

It's not a question of whether remission of T2 Diabetes can occur. The research has shown that constantly. The question is how many can achieve it. Unfortunately we'll never know the true amount until we establish a health system that can provide it.

A thread!

1/14

The research shows that remission is possible for between 20%-75% of those with T2D if weight loss is achieved early enough. But even at 20% that would be over 200,000 Aussies, never mind the amount that would reduce medications. So, what can we learn from the research?
2/14

Dambha-Miller et al (2019) completed a prospective cohort study (N=867) that followed patients for 5 years. They reported that 30% maintained remission over the 5yrs. Achieving >10% weight loss was associated with remission.
3/14

onlinelibrary.wiley.com/doi/full/10.11…

Ried‐Larsen et al (2019) achieved 34% remission at 2 years through an exercise program. They reported remission was associated with an increase in physical fitness.
4/14

portal.findresearcher.sdu.dk/en/publication…

Umphonsathien et al (2019) did a small study in Thailand that showed 79% remission at 12 weeks. This reduced substantially at 12 months as each participant moved back to usual care.

5/14
onlinelibrary.wiley.com/doi/full/10.10…

Sarathi et al (2017) completed a small study in India. 68.8% achieved complete or partial remission (Complete=46.9% at 2yrs, and partial = 21.9% at 2yrs)

6/14

europepmc.org/article/MED/28…

Mollentze et al (2019) ran a Pilot study. Whilst study was small and remission rates weren't high, this study shows the impact on those who don't achieve remission but can dramatically reduce HbA1c and reduce medications.
7/14

link.springer.com/article/10.100…

The DiRECT Trial reported that at 12 months, remission achieved in 47% of intervention compared to 4% in control. 76% of patients who lost >10kg achieved remission. This was completed in 49 primary care locations.

8/14

sciencedirect.com/science/articl…

The 2 year follow up for DiRECT reported remission of 36%. However, over 70% of those who maintained at least 10kg weight loss also maintained remission.

9/14
acpjournals.org/doi/abs/10.732…

Taheri et al (2020) replicated the DiRECT trial format in Qatar and achieved 61% remission at 12 months. This had a younger cohort and there was more emphasis on exercise.

10/14
sciencedirect.com/science/articl…

Hallberg et al (2018) provided a pgm over the internet/phone, and achieved 25% remission at 1yr. However it was the reduction or elimination of insulin in 94% of patients that was impressive.

11/14

link.springer.com/article/10.100…

Also, there's a range of studies been completed on LCD and VLCD diets and remission that are covered in this review

12/14

pubmed.ncbi.nlm.nih.gov/33441384/

Remission may not be for everyone, but if people aren't told, they can't aim for it. If health workers don't know, they cant support people to it. We need to learn from these studies, then provide a format that will work for Australians treated through primary care!

13/14

There was an independent study on my program, 'Too Deadly For Diabetes' (Power et al 2021)
The goal wasn't remission, but to test the feasibility of an Aboriginal led diabetes program in a low socio-economic area. Avg ⬇️in HbA1c was -1.67%!

14/14

onlinelibrary.wiley.com/doi/full/10.11…