Abstract
Diabetes mellitus is characterized by progressive reduction of insulin secretion and increase in insulin resistance. Medical procedures capable of attaining remission of the disease in some patients with type 2 diabetes or deceleration of loss of own insulin secretion exist.
Tight glycemic control using an insulin pump for 14 days in fresh diabetics may lead to achievement of a two-year remission in up to 30 % of patients. The removal of toxic effect of hyperglycemia results in an improvement of insulin secretion, but also in the decrease in insulin resistance.
This method is particularly effective in Asians. The second possibility of diabetes remission achievement is the treatment with a very low energy content diet (600-800 kcal/day).
In the course of several days, the fasting glycemia normalizes and the first phase of insulin secretion is restored. This procedure leads to weight loss and diabetes remission achievement in approximately one half of patients within one year.
The treatment with a low energy fluid diet upon type 2 diabetes manifestation is currently recommended by general practitioners in England. Bariatric surgery has a similar effect on diabetes remission, but the effect is long lasting.
The pathophysiologic consequences as well as the pitfalls of this therapy are discussed in the text. Conclusion: This review presents the importance of protection of residual insulin secretion in patients with type 2 diabetes.
Even if the treatment fails to achieve complete diabetes remission, it is important to protect the beta-cells by normoglycemia and insulin resistance reduction via slimming diet, physical activity and proper selection of medication (pioglitazone, incretins). The protection of residual insulin secretion should be an important goal in the treatment of patients with fresh type 2 diabetes. (C) 2019 TIGIS Spol. s.r.o..
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