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Reducing Diabetes by Reducing Fat From the Pancreas

Study finds insulin secretion returns to normal with one-gram fat loss.

Diabetes affects millions of people in the world. It is a chronic disease that does not go away, even with treatment. Most diabetic patients are insulin resistant, and the beta cells cannot produce enough extra insulin. Currently, more than 44 million Americans are considered to be obese, and excess body fat contributes to insulin resistance, which increases the risk of diabetes. Weight loss is considered the best way to improve the body’s ability to use insulin.

Because of insulin resistance and pancreatic beta cell failure in type 2 diabetes, the current treatment options of T2M are aimed at increasing insulin sensitivity and reducing blood glucose levels. A new study published in Diabetes Care by a team from Newcastle University, UK, found losing less than one gram of fat that is accumulating in the pancreas can reverse diabetes. It means blood glucose levels may go back to normal range if people lose their weight.

Professor Roy Taylor, who was the leader of this research, presented these findings at the World Diabetes Conference in Vancouver. This study examined 18 patients with type 2 diabetes or normal glucose tolerance who were listed for gastric bypass before and 8 weeks after surgery, and patients were matched for age, weight, and sex. Patients were put on a restricted diet for eight weeks, and then researchers measured their hepatic insulin sensitivity, the first-phase insulin response to a stepped intravenous glucose infusion, and glycemic and incretin responses to a semisolid meal. During the trial, 9 patients between the ages of 25 and 65 who had diabetes showed high levels of fat in their pancreas. After the surgery, those with type 2 diabetes were taken off their medications.

The results showed weight loss after surgery was similar in patients with type 2 diabetes or without it, and all patients lost around 13% of their initial body weight. No different effect of incretin secretion was found in both groups after gastric bypass. In addition, the fat in the pancreas decreased to a normal level only in patients with type 2 diabetes, while the non-diabetic patients showed no change in their pancreas fat. The study stated patients with type 2 diabetes lost fat from their pancreas, which allowed the pancreas to secrete normal levels of insulin, and pancreatic triglyceride decreased by 1.2% over the 8 weeks in the diabetic group. The results showed about 0.6g of pancreatic tryglyceride in patients with diabetes. Dr. Taylor said, “For people with type 2 diabetes, losing weight allows them to drain excess fat out of the pancreas and allows function to return to normal.”

This shows that the excess fat in the diabetic pancreas is specific to type 2 diabetes and important in preventing insulin from being made as normal. When that excess fat is removed, insulin secretion increases to normal levels. In other words, they were diabetes free.

There was no doubt that these finding provided a new perspective to treat type 2 diabetes, since type 2 diabetes is incurable and a progressive condition, but which may eventually require insulin injection. Professor Taylor adds, “this new research demonstrates that the change in level of fat in the pancreas is related to the presence of type 2 diabetes in a patient. It is not something that might happen to anyone whether or not they had diabetes. It is specific to type 2 diabetes.”

Practice Pearls:

  • A UK study of obese patients with diabetes or without diabetes assessed the association between insulin secretory function and reducing pancreatic fat by weight loss.
  • The results showed only patients with type 2 diabetes decrease pancreatic fat and restored normal insulin secretion.
  • Losing less than one gram of that fat through weight loss reverses diabetes.
  • The change in level of fat in the pancreas is related to the presence of Type 2 diabetes, but still it needs more studies to exam this results.

Sarah Steven, Kieren G. Hollingsworth, Peter K. Small, Sean A. Woodcock, Andrea Pucci, Benjamin Aribisala, Ahmad Al-Mrabeh, Ann K. Daly, Rachel L. Batterham, and Roy Taylor. Weight Loss Decreases Excess Pancreatic Triacylglycerol Specifically in Type 2 Diabetes.Diabetes Care, December 2015