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Reaction: Weight loss alone has little effect on diabetes control, study finds

Researchers at the University of Hong Kong have analysed data from more than 37,000 patients with type 2 diabetes followed for several years. Although some clinical trials have shown that weight loss can be quite effective in controlling the disease, the study data indicate that in the long term and 'in the real world' this is only achieved in 6% of patients. The results are published in the journal Plos Medicine.

23/01/2024 - 20:00 CET
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Diabetes - Peralta (EN)

Fernando Gómez Peralta

Coordinator of the Diabetes Area of the Spanish Society of Endocrinology and Nutrition (SEEN) and head of the Endocrinology and Nutrition Unit at the General Hospital of Segovia

Science Media Centre Spain

It is an interesting study because of the large sample size, the length of follow-up and the relatively recent data. 

It is also important because achieving remission of type 2 diabetes mellitus is a critical goal after the emergence of treatments that have demonstrated their feasibility (bariatric surgery and GLP1 and similar therapies). 

It is probably a further confirmation that non-pharmacological or non-surgical treatment, i.e. lifestyle measures, at least conventional ones, are minimally effective under real-life conditions. It is therefore a further call to administrations and health systems to include the new drugs (in addition to or instead of bariatric surgery) in early stages of type 2 diabetes mellitus or even in what we currently call pre-diabetes.  

The fundamental questions to be answered in the latter respect would be:  

  1. In which groups these interventions would be really cost-effective (the population with pre-diabetes in developed countries is huge, possibly similar to the prevalence of type 2 diabetes mellitus). 
  2. In which cases would bariatric surgery remain the first option. 

The main limitations of the study are that it was conducted in a Hong Kong population, so we do not know to what extent these data can be extended to other populations or ethnicities; and the lack of data to explain weight loss and the methods used (including surgery).

The author has not responded to our request to declare conflicts of interest
1-year weight change after diabetes diagnosis and long-term incidence and sustainability of remission of type 2 diabetes in real-world settings in Hong Kong: An observational cohort study
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  • Peer reviewed
  • Observational study
  • People
PLoS Medicine
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Wu et al.

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  • Research article
  • Peer reviewed
  • Observational study
  • People
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