·
Eating between 825 and 850 calories a day for
three to five months put the disease into remission in almost half of patients
in a new study·
After one year, participants had lost an
average of 10 kilos (22 lbs)·
Experts say bariatric surgery is effective
but expensive, risky and unnecessary·
Guidelines focus on addressing symptoms with
drugs instead of 'the root cause'·
Big challenge is weight re-gain and if
remission is achievable in the long-term ·
The team therefore plan to do a follow-up
study in four years' time ·
Worldwide diabetes figures are expected to
climb to 642 million by 2040
A low calorie diet can reverse type 2
diabetes and save the lives of millions of sufferers of the preventable
condition, research suggests.
Eating between 825 and 850 calories a day for
three to five months put the disease into remission in almost half of patients
in a new study.
The Diabetes Remission Clinical Trial
(DiRECT), published in The Lancet, looked at almost 300 adults aged 20 to 65
who had been diagnosed with the disease in the past six years.
It showed that participants, who were
instructed to slowly reintroduce more food, after one year had lost an average
of 10 kilos (22 lbs), and half had maintained remission without antidiabetic
medications.
The researchers argue that their findings
show that while bariatric surgery can achieve remission for a large number of
diabetics, this 'expensive and risky' method is not necessary as diet and
exercise alone is 'feasible'.
Restricting calories or fasting is an
increasingly popular method of tackling diabetes. The 5:2 diet, aka The Fast
Diet, is the best known of the fasts to reverse the disease and was made famous
by Dr Michael Mosley.
+2
Eating
between 825 and 850 calories a day for three to five months put the diseases
into remission in almost half of patients in a new study (stock image)
DOES
THIS DIET ALREADY EXIST?
Many
experts have advocated a low calorie diet to control diabetes.
The 5:2
diet, aka The Fast Diet, is the best known of the fasts and was made famous by
Dr Michael Mosley.
Comprising
of five days of regular eating and two ‘fast’ days of 800 calories, it has been
associated with improved DNA repair and brain function.
An
increase in fat loss was also demonstrated in a 2011 Manchester University
study.
Dr Mosley
lost 20lb in 12 weeks and saw his blood sugar and cholesterol levels return to
normal after being pre-diabetic.
He argues
that two days of calorie restriction is achievable for many.
Worldwide,
the number of people with type 2 diabetes has quadrupled over 35 years, rising
from 108 million in 1980 to 422 million in 2014, and is expected to climb to
642 million by 2040.
It affects almost one in ten adults in the
UK, and costs the NHS around £14 billion a year.
Addressing
the 'root cause'
The Newcastle University scientists say that
excess calories lead to a fatty liver, which causes the liver to produce too
much glucose.
The excess fat is then passed to the
pancreas, which causes the insulin-producing cells to fail and thus causing
diabetes.
Their previous research suggested losing less
than one gram of fat from the pancreas can re-start insulin production,
reversing type 2 diabetes.
Co-author Professor Roy Taylor, who has
spent almost four decades studying the condition, said current management
guidelines focus on addressing the symptoms – by reducing blood sugar levels
through drug treatments – instead of 'the root cause'.
'Diet and lifestyle are touched upon but
diabetes remission by cutting calories is rarely discussed,' he said.
'A major difference from other studies is
that we advised a period of dietary weight loss with no increase in physical
activity, but during the long-term follow up increased daily activity is
important.
'Bariatric surgery can achieve remission of
diabetes in about three-quarters of people, but it is more expensive and risky,
and is only available to a small number of patients.
'Our findings suggest that the very large
weight losses targeted by bariatric surgery are not essential to reverse the
underlying processes which cause type 2 diabetes.'
It
is 'achievable for many people'
OBESITY
CRISIS
Obesity is
believed to account for 80-85 per cent of the risk of developing type 2
diabetes.
Recent
research suggests that obese people are up to 80 times more likely to develop
the disease than those with a BMI of less than 22.
The
worldwide obesity rate has doubled since 1980, and the US has the highest rates
of obesity among high-income countries.
Currently,
about one in three American adults are considered obese, and about one in seven
children.
More than
half of children growing up in the US today could be obese by the time they are
middle-aged, worrying research by Harvard University revealed earlier this
week.
It also
emerged this week that Britain has highest numbers of overweight people in the
EU.
Nearly 30
per cent of women and just under 27 per cent of men are overweight, according
to the European Society of Cardiology.
Today
nearly a third of UK children aged two to 15 are overweight or obese.
Experts
warn it has become normal to be vastly overweight in both countries.T
he
weight management programme began with a low calorie diet, followed by stepped
food reintroduction and ongoing support for weight loss maintenance, including
cognitive behavioural therapy.
Antidiabetic and blood pressure-lowering
drugs were all stopped at the start of the programme.
Almost a quarter of the group achieved weight
loss of 15 kg or more at 12 months, and nearly half achieved diabetes remission
at one year, compared with four per cent in the control group.
Critics of low-calorie diets to treat
diabetes argue that such a strict regime are unrealistic for many patients, but
Professor Taylor disagrees.
'The weight loss goals provided by this
programme are achievable for many people,' he said.
'The big challenge is long-term avoidance of
weight re-gain. Follow-up of DiRECT will continue for four years and reveal
whether weight loss and remission is achievable in the long-term.'
Co-author Professor Michael Lean, from the
University of Glasgow, said: 'Our findings suggest that even if you have had
type 2 diabetes for six years, putting the disease into remission is feasible.
'In contrast to other approaches, we focus on
the need for long-term maintenance of weight loss through diet and exercise and
encourage flexibility to optimise individual results.'
Diabetics
should start the plan early
Another expert, who was not involved in the
study, said diabetic patients are best to start a revesal diet when they are
first diagnosed and their motivation is high.
Professor Emeritus Matti Uusitupa, from the
University of Eastern Finland, said: 'Lean and colleagues' results, in addition
to those from other studies of type 2 diabetes prevention and some smaller
interventions in this setting, indicate that weight loss should be the primary
goal in the treatment of type 2 diabetes.
'The DiRECT study indicates that the time of
diabetes diagnosis is the best point to start weight reduction and lifestyle
changes because motivation of a patient is usually high and can be enhanced by
the professional health-care providers.
'However, disease prevention should be
maintained as the primary goal that requires both individual-level and
population-based strategies, including taxation of unhealthy food items to
tackle the epidemic of obesity and type 2 diabetes.'
Dr Elizabeth Robertson, Director of Research
at Diabetes UK, said: 'These first year findings of DiRECT demonstrate the
potential to transform the lives of millions of people. We’re very encouraged
by these initial results, and the building robust evidence that remission could
be achievable for some people.
'The trial is ongoing, so that we can
understand the long-term effects of an approach like this. It’s very important
that anyone living with type 2 diabetes considering losing weight in this way
seeks support and advice from a healthcare professional.'
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