Following a weight loss diet to manage Type 2 diabetes can also lower blood pressure and reduce the need for medication, research has found.
New research has shown that achieving and maintaining a substantial weight loss to manage Type 2 diabetes can also lower blood pressure and reduce, or remove, the need for anti-hypertensive medication.
The findings are based on a weight management programme developed by researchers at the Universities of Glasgow and Newcastle for the Diabetes UK-funded Diabetes Remission Clinical Trial (DIRECT). The study was published in the journal Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).
Low-calorie diet
The programme consists of an initial 12 weeks on a nutritionally complete formula diet (low-calorie soups and shakes) which will induce weight loss of over 15 kg (over two stones) if followed thoroughly. Diabetes and blood pressure drugs were stopped at the start, and only restarted if blood sugar or blood pressure rose.
Following significant weight loss, nutritional support is provided to help participants maintain their weight and lead a healthy lifestyle. Of those who maintained the 15kg weight loss, eight out of ten became free of Type 2 diabetes and did not need to use diabetes medications for at least two years.
Lower blood pressure
Researchers looked at 143 people who started the diet programme, with more than half (78 people) on tablets for high blood pressure at the start (and 44 on two or more drugs). They found that, overall, average blood pressure fell steadily as people lost weight. Additionally, blood pressure remained lower after the formula diet period finished, and then at 12 and 24 months.
For those not previously treated for high blood pressure, blood pressures fell sharply from week one. For those who had stopped their blood pressure tablets, blood pressure still fell, although more slowly. Just over a quarter (28%) needed to reintroduce a blood pressure tablet during the formula diet period. However, researchers also found that the same proportion of participants (28%) were able to remain off their medications for at least two years.
Professor Mike Lean, from the University of Glasgow, said: “We wanted to evaluate the safety and efficacy of withdrawing blood pressure medication when beginning our specially-designed weight-loss programme for Type 2 diabetes, and we are really pleased with the results.
“Our study shows that, in addition to possible remission from Type 2 diabetes, there are other very important health benefits, as weight loss is a very effective treatment for hypertension and its associated serious health risks.
“Currently, over half of all the 4.5 million people with Type 2 diabetes in the UK also require tablets for hypertension, to reduce serious vascular complications. Being overweight is the main cause, and losing weight can bring a remission from hypertension for many, as well as a remission of diabetes. Withdrawing blood pressure medications is safe, provided people lost weight and blood pressure was checked regularly, in case tablets needed to be reintroduced.
“The DiRECT trial was done entirely in primary care. The evidence shows that GPs can safely offer an evidence-based intensive weight management intervention, aiming for substantial weight loss and remission of Type 2 diabetes. The study further highlights the links between diet, weight, Type 2 diabetes and hypertension, and how long-term support to maintain weight loss is vital.”
Reducing the need for medication
Professor Roy Taylor, from Newcastle University, said: “Guidelines encourage doctors to start tablets, but there have been few demonstrations of how tablets can be stopped.
“My patients, like so many, do not like swallowing multiple tablets, and this study is important as we can now reassure them that stopping blood pressure tablets is not only safe but also good for their health. We’ve shown that when substantial weight loss is achieved and maintained, patients can effectively manage both their blood pressure and Type 2 diabetes without drugs.”
