Friday, November 29, 2013

CAN T2DM BE REVERSED? EARLY HOPE

I was reading the facebook page this morning and came across this article which seemed interesting. It appears that one of our Malaysian doctor is trainig in Endocrinology in Newcastle Medical School, NSW and has done a piece of research in the area of the area of Type 2 Diabetes under Prof Rod Taylor. Dr Lim Eu Lin's piece of work for her postgraduate doctorate, was on type 2 diabetes and its reversibility, it would appear from the write up, posted in the Newcastle Press Office bulletine board in July 2011. Dig as I may, I could not find the original paper I suppose it was kept for a thesis. So clinical details are scarce, except from what was in the Newcastle Press statement.
She studied 11 patients with type 2 diabetes and high blood sugar levels. Gave them a 600 cals diet ( mainly liquid diet with low calorie veges ) for 8 weeks and then assess their blood sugars and also use MRI pancreatic imaging ( ? enhancement ). She found that after 8 weeks of this 600 cals diet, 7 of the 11 patients had their pre-breakfast blood sugar returned to normal and their Pancreatic MRI showed less fatty changes. She therefore concluded that in these 7 of 11 patients, their diabetic state has been reversed. I supposed she presumed "cured".
I must say that she has made a good beginning, but certainly the conclusion is way premature. Many details are lacking. What were the data from animal experiment, before embarking on this piece of human research? Although the 11 patients were said to have type 2 diabetes, which stage were they at? I do not suppose they were pre-diabetics or T2DM with target organ damage? Were they impaired glucose tolerance, or frankly diabetic? Is fatty changes on Pancreatic MRI and acceptable way to monitor diabetic disease? The MRI improvement was in the region of 2-3%, certainly not alot. Afterall, the numbers were small, only 11 patients.
Much much more work needs to be done in this area, but Dr Lim has made a beginning.
We await to see more work in this area, as T2DM is a serious health problem in this Malaysia. If Minister's figures are to be believed, there are about  2-3 million T2DM in Malaysia and the number is growing. It is a real health issue consuming much healthcare budget and causing much morbidity and mortality. If someone can really find a cure, that will be great.

For the moment, let us consume less starch and carbs. Maybe the minister should consider compulsory food labelling even for teh tarik and roti canai, and hokkien mee and nasi lemak. Using the carrot approach, using a scheme of tax exemption for all who can maintain ideal BMI. No GST for all healthy food and exercise services. Of ya I forgot my favourate, lifts to every other floor from floor 4 onwards. Hahahaaaaa

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