5 Flaws with Type 2 Diabetes Reversal Studies
Last updated: March 2022
The headlines reporting on type 2 diabetes (T2D) reversal research may sound promising. But the research is not without its flaws. Learn about five of them in the Look AHEAD and DIRECT studies in this short clip.
Transcript of recording:
5 reversal study flaws
When you're living with type two diabetes, it's hard to ignore the headlines about reversal or remission, but the reality is, the research behind those headlines is often pretty shaky. I'm going to give you five flaws that are often not highlighted in the research behind the DIRECT study and the Look AHEAD study.
1. Selective participant criteria
Number one, the people that were picked for these studies about type two diabetes were people that had pretty high-functioning pancreases, meaning their bodies were still able to make a pretty significant amount of insulin. How do we know that? Well, they picked people that had diabetes less than six years and they also picked people who were on no medications at all, or just on one or two diabetes pills. No one was on insulin in the DIRECT study and few, less than 15%, were on insulin in the Look Ahead study.
2. Calorie restriction is unsustainable
Number two, the amount of calories that people were given into these studies was pretty restrictive and the majority of people cannot maintain that few of calories over a long period of time. In fact, that brings us to flaw number three.
3. Level of support is unsustainable
The amount of support that people required in these studies was pretty significant. People had access to dieticians and exercise physiologists and many different health opportunities and appointments to help support them during this time. Now in the real world, it's pretty tough to get an insurance company to pay for that significant kind of support long term.
4. Loose definition of "remission"
Flaw number four, the way remission was defined was pretty loose. There was a consensus statement in 2009 by a group of experts that define diabetes remission in the following way. If someone was off diabetes medications and had an A1c level of less than 6.5% for one year, that would be considered partial remission. They also categorized complete remission as an A1c level of less than 5.7% and off diabetes medications for one year. They considered prolonged remission to be an A1c level, less than 5.7%, off diabetes medications for at least five years.
Now the DIRECT study and the Look AHEAD study both defined reversal of type two diabetes as an A1c less than 6.5% and off medication for one year. Just for perspective, an A1c less than 6.5% is still prediabetes range. So it's not even a gauge on if somebody returned to normal blood sugar levels.
5. Maintenance is not possible for most
Finally, the fifth flaw, the number of people that were able to maintain the reversal of type two diabetes decreased year to year to year, even with all the support, even with all the guidance, even with all the calorie restriction, people's bodies were not able to maintain that reversal level for a long-term period.
There you have it, the five flaws underneath the headlines of type two diabetes reversal.
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