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8 Weeks on a Strict Diet May Get Rid of Diabetes

by Dr. Sharon Orrange on May 2, 2016 at 12:57 pm

When you are diagnosed with type 2 diabetes (also known as adult-onset diabetes), you’re advised to accept it as a lifelong disease that may require oral medications and—for 50% of people with type 2 diabetes—insulin within 10 years.

But what if that wasn’t the case? What if you could follow a strict low calorie diet for 2 months and get rid of your diabetes forever? Well, for some of you, it’s possible. Here’s what you need to know.

  • What changed? From looking at people who have had bariatric (weight loss) surgery, it’s been found that a return to normal glucose control is possible after weight loss in some people with type 2 diabetes. After bariatric surgery, remission of diabetes occurs in 80% of people. So, what about after any sharp decrease in calorie intake? There’s a new study from the journal Diabetes Care that looks at just that question.
  • What did the people in this study do? This study was comprised of three phases: a very low calorie diet (VLCD) for 8 weeks; a stepped return to intake of normal food over 2 weeks; and a weight maintenance program over 6 months. Not surprisingly, weight fell on average 15 kg (33 pounds) over the 8 weeks and much of this weight loss was sustained after 6 months.
  • What was the diet? The very low calorie diet consisted of a liquid diet formula (OPTIFAST) taken as three shakes per day. In addition, up to 240 g of non-starchy vegetables was allowed, giving a total intake of 624–700 calories per day. Drinking at least 2 liters of calorie-free beverages per day and maintaining a normal level of physical activity was encouraged.
  • How does a very low calorie diet for 8 weeks work to resolve diabetes? Fasting blood sugar became normal within days on a very low-calorie diet (VLCD). This is believed to be due to a rapid decrease in liver fat and return of normal liver insulin sensitivity, and normal β-cell (the cells in the pancreas that make insulin) function that returned over that 8 weeks.
  • Does the remission last? At the end of 6 months, after returning to “normal” eating, 40% of study participants had a normal fasting glucose, while taking no diabetes medications or insulin. People who followed the very low calorie diet also had normalization of liver fat (fatty liver changes) and normal insulin sensitivity.
  • Does this mean truly long-term reversal of type 2 diabetes is possible? We don’t know yet. Long-term studies on the same course of action—very low calorie diets followed by weight maintenance programs—are the next step. There are many reports of individuals staying diabetes free for up to 3 years.
  • Take home lesson is that diabetes is potentially reversible in half of motivated people who are willing to follow a very low calorie diet for 2 months followed by weight “maintenance.”

Those are good odds.

Dr O.

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