A study finds evidence that exercise and diet can put type 2 diabetes into remission. Here’s how it works.
Diabetes now affects more than
The disease increases the risk of cardiovascular disease, nerve damage, and kidney damage for those who have it.
But what if a medically supervised crash diet could help put this chronic condition in remission?
Experts in the United Kingdom are looking into whether a strict diet program — a kind of crash diet — can put this normally chronic condition into remission.
To study this treatment, researchers from Newcastle University and the University of Glasgow studied 306 people between the ages of 20 to 65.
The participants had been diagnosed with type 2 diabetes within the past six years, were overweight, and hadn’t started to use insulin.
About half the participants were put into a weight loss program. The other half received normal diabetes care with their general practitioner or primary care physician.
The weight loss program study was called DiRECT, the Diabetes Remission Clinical Trial.
The regimen is a low-calorie diet via shakes and soups for a period of weeks, and then a gradual reintroduction of normal foods.
No exercise was recommended in the beginning of the study. It was introduced as the participants worked to maintain their weight loss.
After one year, the researchers found that
In the group that received normal diabetes care, just six participants went into remission.
Remission was defined as having blood sugar levels below 6.5 percent and being off all diabetes medication for at least two months.
More than half —
Another 34 percent of participants who lost less weight — between 5 and 10 kg (11 to 22 pounds) — still went into remission.
“Our findings suggest that even if you have had type 2 diabetes for six years, putting the disease into remission is feasible,” Michael Lean, a professor and chair of human nutrition at the University of Glasgow and a co-leader of the study, said in a statement.
“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,” he noted.
Obesity is associated with increased risk of type 2 diabetes, but simply losing weight doesn’t mean someone will go into diabetes remission.
Type 2 diabetes results when the body either resists the effects of insulin or when the body doesn’t produce enough insulin for what the body demands.
This disruption strains cells in the pancreas, called beta cells. They can eventually become increasingly impaired, leading to less and less insulin being released.
One participant who took part in the program said it “transformed” her life.
Isobel Murray, 65, was reportedly on the low-calorie diet for 17 weeks and able to shed 16 kg, or approximately 35 pounds.
“When the doctors told me that my pancreas was working again, it felt fantastic, absolutely amazing,” Murray said in a statement. “I don’t think of myself as a diabetic anymore. I get all my diabetes checks done, but I don’t feel like a diabetic. I am one of the lucky ones to have gone into remission.”
However, this approach to combatting diabetes is still being studied. The researchers at DiRECT advise people to seek medical advice before starting any approach to reversing diabetes.
“If you’re thinking about trying a low-calorie diet, it’s really important you speak to your GP and get referred to a dietitian,” Dougie Twenefour, DiRECT deputy head of care said in a statement. “This is to make sure you get tailored advice and support.”
Dr. Goutham Rao, chair of family medicine and community health at the University Hospitals Cleveland Medical Center, said the study adds to a growing body of evidence that steps should be taken to reverse type 2 diabetes.
“The old-school thinking is once a diabetic, always a diabetic,” he said. “But we know from some significant portion of patients who undergo bariatric surgery, for example, that their diabetes goes into remission.”
However, Rao said it’s key that a patient starts to combat type 2 diabetes earlier rather than later if they want to be in remission.
“There is no question, however, that the earlier in the process that you actually make those changes the more likely you are to go into remission,” he said.
He explained that “beta cells in the pancreas, they only have a certain life span per se — and they start to deteriorate year after year after year.”
In particular, Rao said that the new study showed how key it was to have primary care doctors involved in helping people achieve weight loss to combat diabetes.
“Why primary care doctors? The number one reason is that we have ongoing relationships with patients,” Rao told Healthline. “Obesity and diabetes are not onetime things.”
Rao said that it’s important that people with diabetes get support from their doctors and nutrition experts to help them try and get into remission quickly after their diagnosis.
Dr. Ryan Farrell, a pediatric endocrinologist at University Hospitals Cleveland Medical Center, said he hopes this kind of study also sheds light on how to help children and teens who develop type 2 diabetes.
“Type 2 diabetes in pediatrics tends to be a much more aggressive form of diabetes compared to the more latent onset” in adults, Farrell told Healthline.
However, he questioned whether this kind of low-calorie diet approach could work in growing children.
While type 1 diabetes is generally more common in children, rates of type 2 diabetes have been going up dramatically in children.
One study found a nearly 5 percent increase year over year in children with type 2 diabetes
Farrell said he’d like to know how the study participants do in the future and if they’re able to maintain their remission.
“It would be interesting to see to what degree that weight loss is perpetuated and if diabetes reoccurs in any of these patients in subsequent years,” he said.