A recent study examined the effects of combining the diabetes medication dapagliflozin with a calorie-restricted diet on achieving remission of type 2 diabetes. Conducted at 16 centers in China, the randomized, double-blind, placebo-controlled trial involved 328 patients with type 2 diabetes, aged 20-70, who were either overweight or obese. Participants were divided into two groups: one group received dapagliflozin (10 mg/day) along with a calorie restriction of 500-750 kcal/day, while the other received a placebo with the same dietary regimen. The main objective was to evaluate whether this combination could help patients achieve remission of diabetes, defined as having glycated hemoglobin (HbA1c) levels below 6.5% and fasting plasma glucose below 126 mg/dL without the use of antidiabetic drugs for at least two months.

Over a 12-month period, 44% of participants in the dapagliflozin group achieved diabetes remission, compared to 28% in the placebo group. The dapagliflozin group also experienced greater weight loss, with a mean reduction of 5 kg, and significant improvements in other metabolic factors such as blood pressure, body fat, and insulin sensitivity. These results suggest that the combination of dapagliflozin and calorie restriction is an effective way to reverse type 2 diabetes in overweight or obese patients, providing a practical alternative to more intensive treatments like bariatric surgery.

In addition to remission, secondary outcomes showed that participants in the dapagliflozin group had better improvements in glucose control, body fat percentage, and metabolic risk factors, including cholesterol and triglyceride levels. Despite some limitations, such as the inability to generalize findings to those with long-term diabetes or other ethnic groups, the study offers strong evidence that this combined approach could become a feasible and sustainable option for treating early-stage type 2 diabetes. This regimen may be particularly useful for patients who are looking for a more accessible and less invasive treatment option than traditional methods.

Source: bmj.com/content/388/bmj-2024-081820