Fig. 4.

β-cell failure in response to change in lipid parameters during re-emergence of T2DM within DiRECT study. Change from baseline in fasting plasma glucose (a), fasting plasma insulin (b), liver fat (c), hepatic VLDL1-TG production (d), fasting plasma VLDL1-TG (e), total plasma triglyceride (f), intrapancreatic fat (g), and β-cell function (h) at 5 months (responders n = 38; relapsers n = 13), 12 months (n = 28/n = 13, respectively), and 24 months (n = 20/n = 13, respectively). Responders are presented as a solid black line and relapsers as a dashed line. The dotted line is the gridline at y value = 0. Paired data between baseline and each time point are presented. Data are presented as mean ± SEM except for the first phase insulin (median with IQ range) vs. 5 months in relapsers: *P < 0.05, **P < 0.01, ***P < 0.001. Taken from [16], with permission from Cell Metabolism. DiRECT, Diabetes Remission Clinical Trial; T2DM, type 2 diabetes; VLDL-TG, very low-density lipoprotein triglycerides. Responders: Those who achieved remission of diabetes: HbA1c<48 mmol/mol (6.5%) and fasting blood glucose <7.0 mmol/l off all anti-diabetes medicationRelapsers: Those who returned to diabetes state after initial remission.