Future studies will show more, but so far, evidence points to Mounjaro being a long-term drug to be required to take long-term in order to give long-term results. There are always outliers and there are even reports showing that metabolically, patients after a long time experience what’s referred to as a change in their set points. This is in relation to body weight. There are also reports from studies on T2D patients that those early in their diagnosis experienced a remission of diabetes for a period of 3 months after the end of the trial.
“Diabetes remission is having non-diabetes-range blood glucose levels in the absence of any medical therapy or drug treatment for three months. That is the other exciting piece of the data from this treatment. In one of the trials, people in the early course of diabetes used tirzepatide and as many as 50 percent of people treated went into remission, so that really is dramatic. It gives the opportunity to more realistically think of remission as a goal for the treatment of type 2 diabetes.”
A Q&A on Tirzepatide (Mounjaro), a Novel Diabetes Drug, With the ADA’s Dr. Robert Gabbay
“According to recent research, type 2 diabetes cannot be cured, but individuals can have glucose levels that return to non-diabetes range, (complete remission) or pre-diabetes glucose level (partial remission) The primary means by which people with type 2 diabetes achieve remission is by losing significant amounts of weight.
We talk of remission and not a cure because it isn’t permanent. The beta cells have been damaged and the underlying genetic factors contributing to the person’s susceptibility to diabetes remain intact. Over time the disease process reasserts itself and continued destruction of the beta cells ensues. An environmental insult such as weight gain can bring back the symptomatic glucose intolerance.”
Can Type 2 Diabetes Be Reversed?
“From Weight Loss to Type 2 Diabetes “Remission”?
Related to the issue of weight loss as first-line therapy is the concept of type 2 diabetes “remission.” Gabbay noted, “There is a school of thought that says early in the course of disease we probably want to be a lot more aggressive because there’s a greater chance of putting someone into remission. The opportunities for remission after someone has had diabetes for a number of years are relatively low.”
In September 2021, ADA, along with EASD, the Endocrine Society, and Diabetes UK, published a joint consensus statement aiming to standardize use of the term “remission” in type 2 diabetes.
At the ADA meeting, a symposium on Monday afternoon entitled, “Definition and Interpretation of Remission in Type 2 Diabetes,” will cover lifestyle, pharmacotherapy, and metabolic surgery approaches. One noteworthy talk in that session will address the question: “Can Type 2 Diabetes Remission Be Diagnosed While Glucose-Lowering Drugs Are Being Used?”
ADA Scientific Sessions: Tirzepatide and Much More
Medicate Medical News, June 2022
(No paywall, but a Medscape login is required to read for free. You can set up the login on the page.)
“This study demonstrates for the first time the time course of a return of normal beta cell function and hepatic glucose output by acute restriction of dietary energy intake in individuals with type 2 diabetes. The changes occurred in association with decreases in pancreatic and liver triacylglycerol concentrations. This new insight allows an understanding of the causality of type 2 diabetes in individuals as well as in populations. It carries major implications for information to be given to newly diagnosed patients, who should know that they have a potentially reversible condition and not one that is inevitably progressive.”
Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol
Diabetologia, June 2011
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168743/
“Obesity and MetS have been recognized as NAFPD risk factors. NAFPD is strongly associated with non-alcoholic fatty liver disease (NAFLD) and it seems that the presence of both may be related with aggravation of NAFLD. A role of NAFPD in the development of “prediabetes” and T2DM has also been suggested by most human studies. Accumulation of fat in pancreatic tissue possibly initiates a vicious cycle of beta-cell deterioration and further pancreatic fat accumulation. Additionally, some evidence indicates a correlation between NAFPD and atherosclerotic markers (e.g., carotid intima–media thickness). Weight loss and bariatric surgery decreases pancreatic triglyceride content but pharmacologic treatments for NAFPD have not been evaluated in specifically designed studies. Hence, NAFPD is a marker of local fat accumulation possibly associated with beta-cell function impairment, carbohydrate metabolism disorders and atherosclerosis.”
Nonalcoholic Fatty Pancreas Disease: Role in Metabolic Syndrome, “Prediabetes,” Diabetes and Atherosclerosis
Digestive Diseases and Sciences, January 2021