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Low calorie diet

Low calorie diet can reverse long-term T2DM

Overall, 12 patients who had had diabetes for less than ten years reversed their condition six months later they remained diabetes free

A study from Newcastle University has shown that people who reverse their diabetes and then keep their weight down remain free of diabetes. In addition, the team found that even patients who have had T2DM for up to ten years can reverse their condition. The study, ‘Very-Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiologic Changes in Responders and Nonresponders’, published in Diabetes Care, was led by Professor Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, who also works within Newcastle Hospitals.

The research is part of a growing body of evidence showing that people with T2DM who successfully lose weight can reverse their condition because fat is removed from their pancreas, (as reported here in December 2015) returning insulin production to normal. A previous study led by Taylor, published in 2011, showed that diabetes could be reversed by a very low calorie diet. This caused international interest, but the study was very short as it was only eight weeks and the question remained whether the diabetes would stay away.

In this new study, 30 volunteers with T2DM embarked on the same diet of 600 to 700 calories a day. Participants lost on average 14 kilograms and over the next six months they did not regain any weight. The group included many people with longer duration diabetes, defined as more than eight years and ranging up to 23 years.

The diet:

  • Three diet shakes per day and 240 grams of non-starchy vegetables taking in between 600 and 700kcal a day for eight weeks
  • Volunteers then gradually returned to eating normal food over the next two weeks with very careful instruction on how much to eat
  • Volunteers were seen once a month and supported with an individualised weight maintenance programme over the next 6 months
  • To keep weight steady after the weight loss, they were eating around one third less than before the study

Overall, 12 patients who had had diabetes for less than ten years reversed their condition six months later they remained diabetes free. In fact, after six months a thirteenth patient had reversed their diabetes. Though the volunteers lost weight they remained overweight or obese but they had lost enough weight to remove the fat out of the pancreas and allow normal insulin production.

"What we have shown is that it is possible to reverse your diabetes, even if you have had the condition for a long time, up to around ten years. If you have had the diagnosis for longer than that, then don't give up hope - major improvement in blood sugar control is possible,” said Taylor. “The study also answered the question that people often ask me - if I lose the weight and keep the weight off, will I stay free of diabetes? The simple answer is yes!”

A larger trial involving 280 patients is already underway. This will examine how successfully people can reverse their diabetes through weight loss simply under the care of their family doctor and nurse. It is being funded by Diabetes UK.

“Interestingly, even though all our volunteers remained obese or overweight, the fat did not drift back to clog up the pancreas. This supports our theory of a Personal Fat Threshold,” he added. “If a person gains more weight than they personally can tolerate, then diabetes is triggered, but if they then lose that amount of weight then they go back to normal. Individuals vary in how much weight they can carry without it seeming to affect their metabolism - don't forget that 70% of severely obese people do not have diabetes. The bottom line is that if a person really wants to get rid of their Type 2 diabetes, they can lose weight, keep it off and return to normal. This is good news for people who are very motivated to get rid of their diabetes. But it is too early to regard this as suitable for everyone. That is a separate question and a major study is underway to answer this."

The current study was funded by a National Institute for Health Research Biomedical Research Centre (NIHR BRC) grant.

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