Intensive lifestyle and drug therapy can induce remission in some type 2 diabetes patients, according to a new pilot study.

After a four–month intervention, about 70% of patients achieved remission, and about 40% remained in complete or partial remission three months after the intervention ended, Dr. Natalia McInnes of McMaster University in Hamilton, Ontario, and colleagues found.

“It’s still a new area of research, but it’s certainly worth exploring if this works and in whom and how long,” Dr. McInnes told Reuters Health in a telephone interview.

Diabetes can be reversed in some patients with short–term intensive insulin therapy, diabetes medication, intensive lifestyle therapy and diet–based approaches, Dr. McInnes and her team note in their report, published online March 15 in the Journal of Clinical Endocrinology and Metabolism.

The new study compared standard diabetes care to an intensive metabolic intervention lasting eight or 16 weeks in 83 patients who had had type 2 diabetes for three years or less. The intervention consisted of lifestyle approaches along with metformin, acarbose and insulin glargine.

At eight weeks, half of the patients who received eight weeks of treatment were normoglycemic, compared to 3.6% of controls, a significant difference. At 16 weeks, 70.4% of patients in the intervention group were normoglycemic, versus 3.6% of the control group (RR 19.7; 95% confidence interval, 2.83–137.13).

Twelve weeks after the intervention ended, 21.4% of patients in the eight–week treatment group and 10.7% of the controls were in complete or partial remission of diabetes based on HbA1c criteria (RR 2.00; 95% CI, 0.55–7.22).

In the 16–week intervention group, 40.7% were in complete or partial remission 12 weeks after treatment ended, compared to 14.3% of the controls (RR 2.85; 95% CI, 1.03–7.87).

At one year, however, there were no significant differences between the intervention patients and the control patients.

“People who received the four–month intervention did better, but optimal duration is still unknown,” Dr. McInnes said.

Currently, the researcher noted, three multicenter trials are underway across Canada to look at whether a similar intervention can lead to remission lasting for at least one year.

Dr. Ravi Retnakaran of the Leadership Sinai Centre for Diabetes at Mount Sinai Hospital in Toronto, who was not involved in the study, told Reuters Health, “There’s a large body of literature here on the concept that early in the course of type 2 diabetes the pancreatic beta cell defect or dysfunction that leads to diabetes and drives the natural history of diabetes over time has a largely reversible component.”

“The data is most well established with the use of early insulin. This is another study in that setting,” Dr. Retnakaran said in a telephone interview.

The clinical problem that remains, he added, is that this remission is transient. “The real issue is, how do you maintain this,” he said.

He and his colleagues are currently conducting a multicenter randomized controlled trial investigating whether repeating intensive insulin treatment every three months will preserve remission, with results expected in 2019.