Latest news with #DiaRem-1
Indian Express
03-08-2025
- Health
- Indian Express
Rewriting diabetes: PGI study shows remission achievable
For decades, Type 2 diabetes has been viewed as a lifelong, irreversible condition, requiring daily medication, strict dietary control, and constant lifestyle management, but new hope is emerging from India's Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, where a clinical study has shown that remission may be possible through a carefully designed and practical strategy. Type 2 diabetes, which affects millions globally and has become a growing health concern in India, has long been seen as a chronic disease without a cure. Patients are often told they must manage it for life, with pills and blood sugar logs becoming permanent companions, but what if there is a chance to hit reset? Remission is the term scientists are now using, meaning a return to normal blood sugar levels with HbA1c of 6.5% without any diabetes medication for at least three months. However, a made-in-India approach with global promise led by Dr Rama Walia, a team of researchers at PGIMER, launched the DiaRem-1 study, aiming to explore whether tight blood sugar control using modern medicines, combined with lifestyle changes, could push the disease into remission. What makes their work stand out is that it does not rely on extreme weight loss diets or costly surgeries, which are often impractical for many patients. They selected adults diagnosed with Type 2 diabetes in the past five years, whose blood sugar was still reasonably controlled. For three months, these participants were placed on a combination of proven diabetes medications and guided through diet and physical activity. After that, all medications were stopped, and for the following three months, researchers monitored whether their blood sugar levels could remain in the normal range, drug-free. What happened? The results were eye-opening: about one in three participants (31%) achieved diabetes remission, meeting the internationally defined benchmark of maintaining HbA1c below 6.5% without medication for at least three months. Surprisingly, both treatment groups, one using newer medications like liraglutide and dapagliflozin, and the other using more commonly available medicines like glimepiride and vildagliptin, saw similar remission rates. Weight loss helped, but wasn't everything The average weight loss was modest, 4.7 kg in the intervention group and 3 kg in controls. MRI scans in select participants showed dramatic declines in internal fat stores, a 51% drop in liver fat and 48% in pancreatic fat, which are crucial contributors to insulin resistance and worsening diabetes. The science behind the strategy Doctors now understand that two major culprits drive diabetes progression: glucotoxicity (too much sugar damaging beta cells) and lipotoxicity (fat accumulation impairing insulin action). By reversing these with medication and lifestyle therapy, the pancreas gets a much-needed break and, in some cases, begins to function more normally again. Those who achieved remission also had better beta-cell function (as measured by a 'disposition index') and lower levels of insulin resistance (HOMA-IR) compared to those who didn't. Importantly, no single patient characteristic, age, weight, or the duration of diabetes could predict who would succeed, making this approach potentially applicable to a wide range of patients in early stages of diabetes. Side effects and safety: Well-tolerated treatment Minor side effects like nausea were seen, especially in those taking liraglutide, but there were no serious health risks noted. Notably, no patients in the intervention group experienced low blood sugar, a common concern with diabetes medications. A moment of change, not a cure Experts caution that remission is not the same as being cured. Blood sugar levels can rise again without ongoing lifestyle commitment, but the fact that normal levels can be sustained without medication, even temporarily, is a major breakthrough. What's Next? PGIMER's team is continuing research to test how long this remission lasts and whether longer treatment duration might improve outcomes further. But even now, this small but powerful trial offers a cost-effective and scalable strategy that can work in outpatient clinics across India and the world. 'With early, intensive treatment and continued support, many patients may no longer need diabetes medication. That's a powerful message of hope,' said Dr Walia, the lead investigator of the study. 'If you or someone you care about was recently diagnosed with Type 2 diabetes, this study brings an encouraging message: your condition may not be permanent. With early action, close follow-up, and guided treatment, remission is possible, and potentially within reach for many.'
Time of India
02-08-2025
- Health
- Time of India
At PGI, new hope to rein in type-2 diabetes
1 2 Chandigarh: Type 2 diabetes mellitus (T2DM) may not be invincible after all. Researchers are exploring the possibility of achieving remission through a combination of medication and lifestyle changes. The study, 'DiaRem-1' – recently published in the 'Indian journal of endocrinology and metabolism' – challenges the traditional view that T2DM is a permanent condition and provides evidence that remission is a feasible goal for some patients. The DiaRem-1 trial was an open-label, randomised controlled study at a single centre in India. It involved adult patients with T2DM of less than five years duration and an HbA1c level below 8.5% All participants were medicated for three months, followed by a three-month off-treatment period to assess for remission. Remission was officially defined as maintaining an HbA1c below 6.5% without any antidiabetic medication for three months. Nearly a third of the patients achieved remission. This small but powerful trial offers a cost-effective and scalable strategy that can work in outpatient clinics across India and the world. "With early, intensive treatment and continued support, many patients may no longer need diabetes medication. That's a powerful message of hope," said Dr Rama Walia, lead investigator of the study, adding: "Physical workout for an hour daily, including brisk walk, yoga or dance, was advised in the trial. Patients were kept on home-based healthy diet." Unlike other methods that rely on intensive, impractical diets or expensive surgeries, this study focused on using modern, widely available medications along with standard dietary and physical activity advice. Doctors now understand that two major culprits drive diabetes progression: glucotoxicity (too much sugar damaging beta cells) and lipotoxicity (fat accumulation impairing insulin action). By reversing these with medication and lifestyle therapy, the pancreas gets a much-needed break and, in some cases, begins to function more normally again. SWEAT & DIET MAY KEEP PILLS AWAY Chandigarh is considered the diabetic capital of India as the prevalence of prediabetes and diabetes is the highest in the country How Test Was Conducted Participants were divided into two groups: Intervention arm: 14 patients received a combination of liraglutide, dapagliflozin, and metformin. Control arm: 15 patients received vildagliptin, glimepiride, and metformin. Definition of Remission: HbA1c <6.5% for at least 3 months without medication Key Findings Remission Rate: 9 of the 29 participants (31%) achieved remission. Four from the intervention arm and five from control arm maintained HbA1c below 6.5% without treatment Weight Loss: Both groups experienced significant weight loss, as well as reductions in fat mass and body fat percentage. Intervention group had a median weight loss of -4.9 kg and the control group -3 kg, No Special Meds: Both modern and standard drugs helped when tightly managed Hope Floats: Not a cure, but a realistic and hopeful path to freedom from drugs Any Predictors Of Success? No baseline characteristics could be identified to predict which patients would achieve remission. However, those who did achieve remission tended to have a shorter duration of diabetes and greater weight loss. What's Next? PGI team is continuing research to test how long remission lasts and whether longer treatment duration might improve outcomes further Get the latest lifestyle updates on Times of India, along with Friendship Day wishes , messages and quotes !
