Low carb diet puts type 2 diabetes into remission

HeraldScotland Professor Mike Lean

Nearly half of the participants in a weight-loss programme that used low-calorie shakes and soups were in remission after 12 months, despite some having had type 2 diabetes for six years.

In general, weight loss over 10 pounds showed promise of reversing diabetes in patients, the authors concluded.

While obese patients have been known to reverse Type 2 diabetes as a result of massive weight loss following gastric band surgeries, the latest findings show that shedding an average of just 22Ibs is enough to reverse the condition in around half of patients - without any medication.

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.

Professor Taylor said: "These findings are very exciting".

The team believes Type 2 diabetes is caused when accumulated fat in the pancreas and liver interferes with insulin production, which in turn sees blood sugar levels spiking.

Separately, another multi-centre randomly controlled trial called PREVIEW - Prevention of diabetes through lifestyle intervention of population studies in Europe and around the world - is looking at the use of very low energy diets to prevent people from becoming diabetic in the first place.

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'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 food reintroduction phase and beyond increased daily activity is important'.

Some 86 percent of people who lost more than 15kg went into remission, along with 57 per cent of those who lost 10kg to 15kg, and 34 per cent of those who lost 5kg to 10kg.

There were 298 adults on the trial aged 20-65, who had been diagnosed with type 2 diabetes within the last six years, from 49 primary care practices in Scotland and Tyneside.

Prof Taylor said that while bariatric surgery such as gastric bands would reverse diabetes in around three-quarters of patients, it was "more expensive and risky, and is only available to a small number of patients".

The weight loss programme included a low calorie (825-853 calories per day), nutrient-complete diet for 3-5 months, followed by food reintroduction, an increase in physical activity and long-term support to maintain weight loss. "The weight loss goals provided by this program are achievable for many people".

Dr Emily Burns, Diabetes UK acting head of research communications, said: 'Thanks to ground-breaking research like DiRECT we're beginning to change the conversation around Type 2 diabetes, and that's a conversation that Global Positioning System can have with their patients as well. "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 optimize individual results". "The big challenge is long-term avoidance of weight re-gain", he said.

Dr Andrew Green, the BMA GP Committee's prescribing lead, welcomed the results.

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