Study Spotlight

Study Spotlight

Lose weight, reverse type 2 diabetes

Although the onset of type 2 diabetes can seem like a permanent condition, it really isn’t, a British clinical study found. In this six-month trial, people with type 2 diabetes followed a very low calorie diet for eight weeks, then returned to a regimen of weight maintenance for the remainder of the study. Not only did participants lose weight (which remained stable), but 40 percent of them achieved saw fasting blood glucose level drop to 7 mmol/L or less. While it takes extra care and discipline, this latest research shows that type 2 diabetes does not have to remain a chronic condition. It certainly seems like a much more natural and preferable alternative to insulin and diabetes medication.

The study: Very-Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiologic Changes in Responders and Nonresponders

Steven S, Hollingsworth KG, Al-Mrabeh A, et al. Very-Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiologic Changes in Responders and Nonresponders. Diabetes Care. 2016 Mar 21. pii: dc151942. [Epub ahead of print]

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is generally regarded as an irreversible chronic condition. Because a very-low-calorie diet (VLCD) can bring about acute return to normal glucose control in some people with T2DM, this study tested the potential durability of this normalization. The underlying mechanisms were defined.

RESEARCH DESIGN AND METHODS: People with a T2DM duration of 0.5-23 years (n = 30) followed a VLCD for 8 weeks. All oral agents or insulins were stopped at baseline. Following a stepped return to isocaloric diet, a structured, individualized program of weight maintenance was provided. Glucose control, insulin sensitivity, insulin secretion, and hepatic and pancreas fat content were quantified at baseline, after return to isocaloric diet, and after 6 months to permit the primary comparison of change between post-weight loss and 6 months in responders. Responders were defined as achieving fasting blood glucose <7 mmol/L after return to isocaloric diet.

RESULTS: Weight fell (98.0 ± 2.6 to 83.8 ± 2.4 kg) and remained stable over 6 months (84.7 ± 2.5 kg). Twelve of 30 participants achieved fasting plasma glucose <7 mmol/L after return to isocaloric diet (responders), and 13 of 30 after 6 months. Responders had a shorter duration of diabetes and a higher initial fasting plasma insulin level. HbA1c fell from 7.1 ± 0.3 to 5.8 ± 0.2% (55 ± 4 to 40 ± 2 mmol/mol) in responders (P < 0.001) and from 8.4 ± 0.3 to 8.0 ± 0.5% (68 ± 3 to 64 ± 5 mmol/mol) in nonresponders, remaining constant at 6 months (5.9 ± 0.2 and 7.8 ± 0.3% [41 ± 2 and 62 ± 3 mmol/mol], respectively). The responders were characterized by return of first-phase insulin response.

CONCLUSIONS: A robust and sustainable weight loss program achieved continuing remission of diabetes for at least 6 months in the 40% who responded to a VLCD by achieving fasting plasma glucose of <7 mmol/L. T2DM is a potentially reversible condition.

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