The reduction of visceral fat can significantly improve insulin sensitivity in people with prediabetes and lead to metabolic normalization. If those affected can be brought into remission, the risk of manifest type 2 diabetes can be significantly reduced. This has been shown by researchers at the German Center for Diabetes Research (DZD).
It has only been known for a few years that manifest type 2 diabetes can be brought into remission in some people by reducing their weight. The decisive factor here is the ability to boost insulin secretion, whereby reducing the fat content of the liver and pancreas plays an important role.
Differences in sensitivity, not in secretion
The detailed analysis showed that insulin sensitivity is apparently decisive for the answer to the question of whether remission occurs or not. Insulin sensitivity improved significantly more in responders than in non-responders: in responders it was on average 291 ml/(min × m2) at the beginning and 378 ml/(min × m2) after 12 months, whereas in non-responders insulin sensitivity improved to a lesser extent from 278 to 323 ml/(min × m2). Insulin secretion, on the other hand, showed no change in either responders or non-responders over the course of the study - this is a significant difference to remission in manifest type 2 diabetes.
Differences in visceral fat, not liver fat
Further research drew the researchers' attention to visceral adipose tissue: responders were characterized by a significantly greater reduction in abdominal fat than people whose glucose levels did not normalize over the course of the study. Given the importance of visceral adipose tissue for the development of a diabetic metabolic disorder, this fits well into the picture. In terms of liver fat reduction, the two groups - surprisingly - did not differ.
According to the new data, the abdominal circumference should be reduced by at least 4 cm in women and by at least 7 cm in men - then there are relevant chances of remission of prediabetes. The researchers consider it to be proven that a corresponding intervention is actually worthwhile: Study participants in remission still had a significantly reduced risk - by 73% - of developing manifest type 2 diabetes two years later, and a benefit could also be verified with regard to vascular and kidney health.
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