Study reveals type 2 diabetes remission can restore pancreas
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A new research being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), held online this year, demonstrates for the first time that reversing type 2 diabetes can also restore the pancreas to a normal size and shape.

In the study, 64 participants from the landmark Diabetes Remission Clinical Trial (DiRECT) and 64 age-, sex-, and weight- matched controls without type 2 diabetes were measured over 2 years for pancreas volume and fat levels, and irregularity of pancreas borders using a special MRI scan. Beta cell function—key to the body's ability to make and release insulin—was also recorded. Responders (people in remission) were classified as achieving a glycated haemoglobin A1c (HbA1c) level of less than 6.5% and fasting blood glucose of less than 7.0 mmol/l, off all medications.

At the start of the study, average pancreas volume was 20% smaller, and pancreas borders more irregular, in people with diabetes compared with controls without diabetes.

After 5 months of weight loss, pancreas volume was unchanged irrespective of remission. However, after 2 years, the pancreas had grown on average by around one fifth in size in responders compared with around a twelfth in those who did not.

In addition, responders lost a significant amount of fat from their pancreas (1.6%) compared with non-responders (around 0.5%) over the study period, and achieved normal pancreas borders.

Similarly, only responders showed early and sustained improvement in beta-cell function. After 5 months of weight loss, the amount of insulin being made by responders increased and was maintained at 2 years, but there was no change in non-responders.

"These findings provide proof of the link between the main tissue of the pancreas which makes digestive juices and the much smaller tissue which makes insulin, and open up possibilities of being able to predict future onset of type 2 diabetes by scanning the pancreas", says researchers.