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Weight loss programme 'can reverse diabetes'

By
WebMD UK Health News
Medically Reviewed by Dr Rob Hicks
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5th December 2017 – People who are diagnosed with type 2 diabetes may be able to reverse the condition with a strict weight loss programme, results from a new study suggest.

Researchers say remission of type 2 diabetes is possible with a structured, low-calorie diet, and means that diabetes medication would not be needed.

Initial results suggest that almost half of people with the condition could benefit from this approach.

Diabetes remission trial

The findings come from the first year of a 2-year study called the Diabetes Remission Clinical Trial (DiRECT).

The DiRECT trial involved 298 adults recruited from 49 primary care practices in Scotland and the Tyneside region of England who had been diagnosed with type 2 diabetes in the previous 6 years.

Participants were randomly assigned to receive either standard care from their GP or a structured weight management programme within primary care.

Calorie restriction

The weight loss programme consisted of a low energy formula diet of between 825 and 853 calories each day for 3 to 5 months. This compares to the usual daily recommendation of 2,500 calories for men and 2,000 calories for women.

This was followed by a structured re-introduction of food over 2 to 8 weeks in which dietary intake was aligned to about 50% carbohydrate, 35% fat and 15% protein.

Participants received monthly help in the later stages of the programme in losing weight.

Diabetes medication and blood pressure tablets were discontinued on the first day of the trial and reintroduced in accordance with national guidelines, if necessary.

Blood pressure drugs were withdrawn because blood pressure numbers drop quickly when people start low energy diets.

Weight loss

The study, published in the medical journal The Lancet, showed that after 1 year, participants had lost an average of 10kg (22lbs). The initial results show that:

  • 45.6% of participants were in remission for type 2 diabetes after 12 months
  • 34% of people who lost between 5kg (11lbs) and 10kg (22lbs) were in remission
  • 57% of people who lost between 10kg (22lbs) and 15kg (33lbs) achieved remission
  • 86% of people who lost 15kg (33lbs) or more put their diabetes into remission

Remission was defined as having blood sugar levels ( HbA1c) of less than 6.5% (48mmol/mol) at 12 months while not taking any diabetes medications for at least 2 months.

The researchers, from the University of Glasgow and Newcastle University, say their findings add to evidence that remission from type 2 diabetes is closely related to weight loss. They say the programme provides a viable alternative to invasive, weight loss surgery and has the added advantage of being available via primary care.

'It felt fantastic'

Isobel Murray, 65, from North Ayrshire who took part in the DiRECT trial, put her diabetes into remission after the first 4 months and no longer takes medication. She told Diabetes UK, which funds the trial: "It has transformed my life. I had type 2 diabetes for 2 to 3 years before the study. I was on various medications which were constantly increasing and I was becoming more and more ill every day. When the opportunity came to go on the DiRECT study, I had absolutely no hesitation.

"When the doctors told me that my pancreas was working again, it felt fantastic, absolutely amazing. 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."

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