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Recent clinical trials in China reveal the promising benefits of combining the drug dapagliflozin with calorie restriction, resulting in higher diabetes remission among overweight adults.
This discovery provides a potential new strategy for clinical management of early type 2 diabetes, offering a less intensive alternative than bariatric surgery or extreme diets.
Research published in the BMJ outlines a trial conducted across China with overweight adults diagnosed with early stage type 2 diabetes, comparing remission rates between a group receiving both dapagliflozin and moderate calorie restriction and another receiving calorie restriction with a placebo. Results indicated a remission rate of 44% in the dapagliflozin group versus 28% in the placebo group, showcasing a notable increase in effectiveness when combining the medication with diet. The trial also highlighted improvements in body weight, insulin resistance, and metabolic risk factors.
Incorporating pharmacotherapy, like SGLT-2 inhibitors, alongside lifestyle modifications such as calorie restriction, forms a powerful strategy for managing diabetes. This dual approach leverages the benefits of medication-induced glucose control with the natural weight-reducing effects of diet.
"Our multicenter, double blind and randomized trial showed that the combined regimen of dapagliflozin and regular calorie restriction was effective in achieving remission of diabetes, lowering body weight, and improving metabolic risk factors among overweight or obese patients with type 2 diabetes."
The trial showed a significant increase in remission rates with this combination regimen, suggesting its viability as an alternative to more invasive methods like bariatric surgery. Thus, it provides a less daunting option for patients and practitioners.
Traditional methods for inducing diabetes remission often involve significant lifestyle changes or surgical interventions. Very low energy diets and bariatric surgery, although effective, are not always practical or acceptable for many patients due to their invasive or restrictive nature.
The study indicates that the combination of dapagliflozin with moderate calorie restriction offers a more manageable approach. This dual regimen can be easier for patients to adhere to and is feasible in many clinical settings, targeting metabolic improvements without drastic measures.
The trial results not only reveal significant findings but also open avenues for future research. As the study authors noted, more targeted studies could focus on specific patient groups or explore the long-term sustainability of this combined approach.
Additionally, enhancements in understanding the pharmacological mechanisms of SGLT-2 inhibitors and their interaction with dietary changes may inform individualized treatment plans, tailoring interventions to patient needs.
Liu, Y., Chen, Y., & Ma, J. (2025). Dapagliflozin plus calorie restriction for remission of type 2 diabetes: multicentre, double blind, randomised, placebo controlled trial. BMJ, 388(1), 1-12. DOI: 10.1136/bmj-2024-081820