As the incidence of diabetes continues to increase globally, the fight against this chronic condition continues. New research explains not only what triggers type 2 diabetes but also how to reverse the condition. The findings also shed light on what leads to remission after reversal for some people.

Between 1980 and 2014, the number of people living with diabetes across the world increased from about 108 million to 422 million.

As many as 90% of these individuals have type 2 diabetes.

Pharmacological interventions have done little to stop what some have referred to as the diabetes pandemic.

Lifestyle interventions, however, may succeed where other approaches have failed.

A couple of years ago, Medical News Today reported on the first results of a clinical trial, which showed that intensive weight loss programs could help people with type 2 diabetes achieve remission without taking any medication.

The trail was called the Diabetes Remission Clinical Trial (DiRECT), and one of its co-leaders was Prof. Roy Taylor from Newcastle University in the United Kingdom.

But how does this remission occur, and can it last in the long term? Why do some people achieve lasting remission while for others, the condition returns?

Prof. Taylor set out with his team to answer these questions, using data from the DiRECT trial and applying cutting-edge imaging and blood monitoring techniques.

The researchers published their findings in the journal Cell Metabolism.

Testing the ‘twin cycle hypothesis’

The study aimed to test — and confirm — the so-called twin cycle hypothesis, which Prof. Taylor and team put forth more than a decade ago.

The theory proposed that type 2 diabetes results from the accumulation of fat in the liver, which induces insulin resistance and increases blood sugar production.

These effects, in turn, increase plasma insulin levels, precipitating “a self-reinforcing cycle” in which insulin stimulates fat production.

These increased levels of liver fat cause the lipids to overspill into several tissues, including the pancreas.

Beta-cells, which are responsible for creating insulin, are located in the pancreas. “Long-term exposure to saturated fatty acids is harmful to [beta]-cells,” write the authors.