Most of the studies that have been carried out only consider obese people for patients (e.g. DiRECT had minimum BMI of 25kg/m2). That excludes everybody with a healthy BMI from the study. Even though 10% of people with T2 diabetes aren’t overweight. So how do you put your T2 diabetes into remission if you don’t need to lose weight?
A parallel study to DiRECT, ReTUNE, has shown that weight loss, even when not needed to achieve a low BMI, leads to T2 remission (70% of participants at 1 year).
An interesting concept coming out of the study is that BMI and obesity isn’t a meaningful criterion when judging if remission through weight loss is possible. They put forward the concept of “too heavy for your own body“, no matter what your absolute weight or BMI are.
It seems to show that you can create a fatty liver, and therefore the preconditions for diabetes, even if you look thin.
That’s really interesting because it means that T2D is very individual and might affect people you wouldn’t expect to develop it. Also it means that potentially a lot more people are at risk.