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New research has shown that when people achieve and maintain significant weight loss to manage their type 2 diabetes, many people can also effectively control their high blood pressure and stop or reduce their antihypertensive drugs.
A weight management program developed by researchers from the Universities of Glasgow and Newcastle for the Diabetes UK-funded clinical trial DIabetes REmission (DIRECT) has been shown to be effective in lowering blood pressure and reducing the need for antihypertensive drugs in type 2 remission -Diabetes.
The program initially comprises 12 weeks with a nutritionally complete formula diet (low-calorie soups and shakes), which, if fully followed, leads to a weight loss of over 15 kg (over 2 stones). Diabetes and blood pressure medication were stopped at the beginning and only restarted when blood sugar or blood pressure rose.
The weight loss phase is followed by assistance with food choices and a conscious diet to maintain weight. Maintaining the 15kg weight loss enabled 8 out of 10 people to become type 2 diabetes free for at least 2 years without the need for diabetes medication.
This study, published in the journal Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]), studied 143 people who started the diet program, with more than half (78 people) starting high blood pressure pills (and 44 people on two or more drugs). The researchers found that the overall mean blood pressure steadily decreased as people lost weight. And the blood pressure stayed lower after completing the formula diet, and then after 12 and 24 months.
In those who had not previously been treated for high blood pressure, blood pressure dropped sharply from the first week onwards. Those who stopped taking their blood pressure pills continued to drop, albeit more slowly. Just over a quarter (28%) required reintroduction of a blood pressure pill during the formula diet period. However, the researchers also found that the same proportion of participants (28%) were able to go without their medication for at least two years.
Prof. Mike Lean of the University of Glasgow said, “We wanted to evaluate the safety and effectiveness of stopping blood pressure medication at the start of our specially designed weight loss program for type 2 diabetes and are very pleased with the results.
“Our study shows that in addition to possible remission of type 2 diabetes, there are other very important health benefits as weight loss is a very effective treatment for high blood pressure and the serious health risks associated with it.
“Currently, over half of the 4.5 million people with type 2 diabetes in the UK also need high blood pressure pills to reduce serious vascular complications. Obesity is the main culprit, and weight loss can also lead to high blood pressure remission for many. ”It is safe to stop taking blood pressure medication provided people have lost weight and have their blood pressure checked regularly in case the tablets need to be reintroduced.
“The DiRECT study was carried out entirely in primary care. The evidence shows that GPs can safely offer evidence-based intensive weight management intervention aimed at significant weight loss and remission from type 2 diabetes. The study further highlights the links between diet, weight, type 2 diabetes and high blood pressure and the importance of long-term support in maintaining weight loss. “
Newcastle University Professor Roy Taylor said: “Guidelines encourage doctors to start taking pills, but there has been little demonstration of how to stop pills.
“My patients, like so many, do not like to swallow multiple tablets, and this study is important as we can now assure them that stopping blood pressure tablets is not only safe but good for their health, and loss is achieved and sustained, patients can effectively treat both her blood pressure and type 2 diabetes without medication. “
Dr. Wilma Leslie, University of Glasgow, said, “The potential of eliminating blood pressure and diabetes medicines is a huge incentive for people. We hope our results will convince health professionals that this is possible and the wider provision of diabetes remission services. “
Dr. Elizabeth Robertson, Director of Research at Diabetes UK, said, “These important results show that Diabetes UK-funded DiRECT low calorie weight loss program is helping some people not only get some people into remission but also reduce their type 2 diabetes may cause blood pressure, which can allow some people to safely stop taking their blood pressure medication.
“We’re excited to see more evidence of the life-changing effects of the DiRECT program on people’s health. This makes us even more determined to ensure that as many people as possible have access to treatments for type 2 diabetes.”
The study “Antihypertensive Drug Requirements and Blood Pressure Control with Weight Loss in the Diabetes Remission Clinical Trial (DiRECT)” is published in Diabetologia.
Hope of Weight Loss for Patients with Type 2 Diabetes
More information:
Wilma S. Leslie et al., Antihypertensive Medication Needs and Blood Pressure Control with Weight Loss in the Diabetes Remission Clinical Trial (DiRECT), Diabetologia (2021). DOI: 10.1007 / s00125-021-05471-x
Quote: Diet for diabetes remission also lowers blood pressure and reduces the need for medication (2021 June 1), accessed June 1, 2021 from https://medicalxpress.com/news/2021-06-diabetes-remission-diet-lowers -blood.html
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