Deciphering the Role of Incretin Hormones in Weight Loss-induced Remission of Type 2 Diabetes (DIABeat)

Deciphering the Role of Incretin Hormones in Weight Loss-induced Remission of Type 2 Diabetes

The goal of this mechanistic study is to investigate the role of incretin hormones on weight loss-induced type 2 diabetes remission.

Participants will undergo an intensive, individualized dietary treatment to achieve a 10% reduction in body weight, during which glucose-lowering therapy will be withdrawn. Before and after the intervention, the patients will undergo:

• measurement of fasting glucose and glycated hemoglobin
• Indirect calorimetry
• oral glucose tolerance test
• intravenous glucose tolerance test
• quality of life and diet-related questionnaires
• 72-hour food records

At the end of the protocol, subjects will be followed up to maintain lifestyle changes and intercept cases of diabetes relapse.

Inclusion Criteria:

• T2D for less than 6 years;
• age 18-65 years;
• both genders;
• BMI 27-45 kg/m2;
• HbA1c 48-108 mmol/mol (43-108 mmol/mol if on glucose-lowering drugs).

Exclusion Criteria:

• type 1 or secondary/genetic diabetes;
• treatment with insulin, Glucagon-Like Peptide-1 agonists, Gastric Inhibitory Peptide/GLP-1 co-agonists, or pioglitazone;
• weight loss >5% within the previous 6 months;
• eGFR <30 ml/min/1.73m2;
• myocardial infarction within the previous 6 months;
• severe heart failure (NYHA III-IV); eating disorder; substance abuse;
• severe depression;
• known cancer;
• pregnancy.