Modelling Type 2 Diabetes: Investigating Relapse Post Remission

Abstract

Remission from type 2 diabetes, corresponding to sufficiently lowering high fasting plasma glucose concentration or glycated haemoglobin, may be achieved rapidly by the overweight or obese, by following weight loss guidelines. However, remission is often rapidly followed by relapse to higher glucose levels. Earlier modelling predicted that rapid relapse over a few weeks at higher -fat masses may be caused by calorie restriction abandoned too early and that calorie restriction to moderate levels should result in sustainable remission, if dedifferentiated β-cells are capable of recovery. In this chapter, modelling predicts that irreversible β-cell dysfunction, often seen in conjunction with overweight or obese type 2 diabetes of longer duration, may cause slower relapse at moderate -fat masses. Understanding relapse post remission at different fat masses may help formulate advice.