First published on 24 June 2011.
A Newcastle University team has discovered that Type 2 diabetes can be reversed by an extreme low calorie diet alone.
A Newcastle University team has discovered that Type 2 diabetes can be reversed by an extreme low calorie diet alone.
A Newcastle University team has discovered that Type 2 diabetes can be reversed by an extreme low calorie diet alone.
A Newcastle University team has discovered that Type 2 diabetes can be reversed by an extreme low calorie diet alone.
"This is a radical change in understanding Type 2 diabetes." -Professor Roy Taylor
Affecting two and half million people in the UK – and on the increase – Type 2 diabetes is a long-term condition caused by too much glucose, a type of sugar, in the blood.
In an early stage clinical trial of 11 people, funded by Diabetes UK, all reversed their diabetes by drastically cutting their food intake to just 600 calories a day for two months. And three months later, seven remained free of diabetes.
Professor Roy Taylor of Newcastle University who led the study and also works for the Newcastle-Upon-Tyne Hospitals NHS Foundation Trust said: “To have people free of diabetes after years with the condition is remarkable - and all because of an eight week diet.
“This is a radical change in understanding Type 2 diabetes. It will change how we can explain it to people newly diagnosed with the condition. While it has long been believed that someone with Type 2 diabetes will always have the disease, and that it will steadily get worse, we have shown that we can reverse the condition.”
The results of the diet shown to reverse Type 2 diabetes
Research revealed at the American Diabetes Association conference and published in Diabetologia transforms thinking on diabetes. It demonstrates that people who go on a very low calorie diet can remove fat which is clogging up the pancreas allowing normal insulin secretion to be restored.
Traditionally, it has been thought that as a progressive condition, Type 2 diabetes can be controlled by diet initially then tablets, but may eventually require insulin injections.
Type 2 diabetes, which was once known as adult-onset diabetes, is now found in young adults and children. It is caused by too much glucose in the blood due to the pancreas not producing enough insulin - a hormone which breaks down glucose into energy in the cells – or due to the body not reacting to it, known as insulin sensitivity.
Under close supervision of a medical team, 11 people who had developed diabetes later in life were put on an extreme diet of just 600 calories a day consisting of liquid diet drinks plus 200 calories of non-starchy vegetables. They were matched to a control group of people without diabetes and then monitored over eight weeks. Insulin production from their pancreas and fat content in the liver and pancreas were studied.
After just one week, the Newcastle University team found that their pre-breakfast blood sugar levels had returned to normal
A special MRI scan of their pancreas revealed that the fat levels in the pancreas had returned from an elevated level to normal (from around 8% to 6%). In step with this, the pancreas regained the normal ability to make insulin and as a result, blood sugar after meals steadily improved.
The volunteers were then followed-up three months later. During this time they had returned to eating normally but had received advice on portion size and healthy eating. Of the ten people re-tested, seven remained free of diabetes.
“We believe this shows that Type 2 diabetes is all about energy balance in the body,” explained Professor Taylor, “if you are eating more than you burn, then the excess is stored in the liver and pancreas as fat which can lead to Type 2 diabetes in some people. What we need to examine further is why some people are more susceptible to developing diabetes than others.”
Dr Iain Frame, Director of Research at Diabetes UK, said: “We welcome the results of this research because it shows that Type 2 diabetes can be reversed, on a par with successful surgery without the side effects. However, this diet is not an easy fix and Diabetes UK strongly recommends that such a drastic diet should only be undertaken under medical supervision. Despite being a very small trial, we look forward to future results particularly to see whether the reversal would remain in the long term.”
“I no longer needed my diabetes tablets”
Gordon Parmley, 67, from Stocksfield in Northumberland took part in the trial. He said: “I love playing golf but I was finding that when I was out on the course sometimes my vision would go fuzzy and I would have trouble focussing. It was after this that I was diagnosed with Type 2 diabetes. That was about six years ago and from then on, I had to control the diabetes with a daily combination of tablets - the diabetes drug, gliclazide and tablets for my cholesterol.
“When my doctor mentioned the trial I thought I would give it a go as it might help me and other diabetics. I came off my tablets and had three diet shakes a day and some salad or vegetables but it was very, very difficult and I’m not sure I’d have done it without the support of my wife who went on a diet alongside me.
“At first the hunger was quite severe and I had to distract myself with something else – walking the dog, playing golf – or doing anything to occupy myself and take my mind off food but I lost an astounding amount of weight in a short space of time.
“At the end of the trial, I was told my insulin levels were normal and after six years, I no longer needed my diabetes tablets. Still today, 18 months on, I don’t take them. It’s astonishing really that a diet – hard as it was – could change my health so drastically. After six years of having diabetes I can tell the difference - I feel better, even walking round the golf course is easier.
Reference: Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol, E. L. Lim & K. G. Hollingsworth & B. S. Aribisala & M. J. Chen & J. C. Mathers & R. Taylor. Diabetologia. DOI 10.1007/s00125-011-2204-7
Update from August 2013: Following media publicity for this research, Professor Roy Taylor has advised the Hairy Bikers for the BBC series "Hairy Dieters: How to love food and lose weight", aided journalist Richard Doughty in returning his blood sugar to normal levels after a diagnosis of Type 2 diabetes and completed numerous media interviews. For interviews with Prof Taylor please call the University press office: 0191 208 7850
Update from 1 March 2016: Professor Roy Taylor participated in a live interview on Reddit AMA, where he answered questions about reversing Type 2 diabetes.
First published on 24 June 2011.
Reversing Type 2 Diabetes
Our work has shown that type 2 diabetes is not inevitably progressive and life-long. By identifying the causative mechanisms of the condition it has been possible to design appropriate management. We have demonstrated that in many people who have had type 2 diabetes for up to 10 years, major weight loss returns insulin secretion to normal. For practical information on how to reverse your diabetes, scroll down and read the 'Public Information' tab.
It has been possible to work out the basic mechanisms which lead to type 2 diabetes. The Twin Cycle Hypothesis of 2008 has been tested and found to be correct. Too much fat within liver prevents normal insulin action and too much fat within the pancreas prevents normal insulin secretion. Both defects are reversible by substantial weight loss.
A crucial point is that individuals have different levels of tolerance of fat within liver and pancreas. Only when a person has more fat than they personally can cope with does type 2 diabetes develop. In other words, once a person crosses their personal fat threshold, type 2 diabetes develops. Once they successfully lose weight and go below their personal fat threshold, diabetes will disappear.
Some people can tolerate a BMI of 40 or more without getting diabetes. Others cannot tolerate a BMI of 22 without diabetes appearing, as their bodies are set to function normally at a BMI of, say 19. This is especially so in people of South Asian ethnicity.
Award of major grant
In October 2013, Diabetes UK announced the award of its largest research grant ever. It builds upon the breakthrough in understanding the pathophysiology of diabetes and the related demonstration that short term Type 2 diabetes could be reversed to normal. This is brought together with work conducted in Glasgow on use of low calorie liquid diets in primary care.
The study will answer two main questions:
Can type 2 diabetes be routinely reversed in Primary Care?
Is the long term effect of this intervention better than conventional treatment?
The study will be known as DiRECT (DIabetes REmission Clinical Trial). Participating general practices in Newcastle and Glasgow will be randomised either to use the low calorie diet followed by an intensive weight maintenance phase, or to best possible care according to current guidelines. In order to deliver the low calorie diet, together with the critically important backup and support, primary care staff will be trained by the study team.
The expertise of academic staff at Glasgow and Newcastle will be combined with previous experienced specialist dieticians from Counterweight Ltd. Counterweight was formed as a company in order to keep together the expertise developed during the Counterweight Project which has been highly successful in achieving and maintaining weight loss in the primary care setting.
Study volunteers in the Newcastle area will also undergo detailed magnetic resonance investigations coupled with metabolic tests to examine further the basic mechanisms which bring about the return to normal blood glucose control. Additionally, detailed psychological assessments will be carried out to understand the response of individuals to this management approach and identify factors which effect adherence.
This study is a collaboration between Professor Mike Lean, Professor of Human Nutrition at Glasgow University and Professor Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, as the Chief Investigators.
The Principal Investigators are:
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