Drastic diet 'reverses' Type 2 diabetes

[Jill]

I'm not sure they've 'fixed' it but they have certainly reduced, maybe only temporarily the levels of circulating NEFA (free fatty acids) These are believed to a major factor in producing insulin resitance.
I don't know if you want to read the evidence for this but if you google free fatty acids cause insulin resistance you'll find the major papers.

I've just looked up 'NEFA' and the definition was non-esterified ('free' or unsaturated) fatty acids. I though unsaturated fats were the good guys? The more I learn, the more confused I become.

 

[HelenM]

Help, I thought Wiki would explain but that explanation is very chemical.
http://en.wikipedia.org/wiki/Fatty_acid_metabolism

Basically, in this case these are fatty acids in bloodstream.
When fat in the form of triglycerides, is broken down it forms glycerol and 3 molecules of fatty acid. (hence the name) These can be used in various ways to provide needed energy. They can also recombine and be stored in the liver and fat cells, to be broken up again. Your stored fat doesn't just sit there doing nothing!
Elevated levels of FFAs are linked with insulin resistance.(and why they might be elevated is another essay ) but it's noticeable that in this study they rose initially, then fell and then fell even more in the 12 weeks after the diet.

 

[woolstone2]

doing my best to be a good neighbour and give lifts to friends stood at bus stop, (thin and non diabetic), i was advised to read and follow the news item as i could get rid of my diabetes didnt i know.......mmmmm....me said through gritted teeth..... i already have dieted my way to great control by v low carb/high fat diet thanks very much.
Came back home to a long diatribe by my mother on the phone saying the same thing. the school playground mums did the same?? I am pis**d off, but not sure why so much! big hugs to all....(jeese its hot tonight!!!)julie

 

[Caroline]

I wonder if the people in the trial were all working? I am away from home for 12 hours every day because I work full time and with so few calories I think I'd be asleep at my desk....

 

[FM001]

Would anyone want to follow such a restrictive diet where you are in near starvation mode, as the article is unclear on what the calorie consumption is after the reversal takes place it is difficult to comment on whether you could personally maintain it for life, but I suppose in some respects this research and its findings are a step in the right direction.

 

[everydayupsanddowns]

As a reminder from the original reports: The starvation period was 8 weeks and was only under strict medical supervision (it is not suggested people should 'try this at home').

Following the trial some (but by no means all) participants seemed to recover normal-ish pancreatic function and could pass(ish) an OGTT.

From the BBC: http://www.bbc.co.uk/news/health-13887909

Three months after the end of the diet, when participants had returned to eating normally and received advice on healthy eating and portion size, most no longer suffered from the condition.

It is not clear how long the reversal/remission might last and it clearly won't work for everyone.

Type 2's should eat "lots of starchy carbohydrate at every meal" though? Errrrm. No!

 

[Mark T]

...Following the trial some (but by no means all) participants seemed to recover normal-ish pancreatic function and could pass(ish) an OGTT...

...It is not clear how long the reversal/remission might last and it clearly won't work for everyone...

From the report, re-formatted for clarity (number in brackets are values at 8 weeks);

At follow-up 12 weeks after completion of the dietary intervention,
- Mean weight gain was 3.1 ? 1.0 kg.
- fasting plasma insulin concentrations increased 65 ? 15 pmol/l (was 57 ? 11)
- fasting plasma NEFA dropped to 0.54 ? 0.05 mmol/l (was 0.72 ? 0.06).
- HbA1c increased to 6.2 ? 0.1% (was 6.0 ? 0.2)
- fasting plasma glucose increased 6.1 ? 0.2 mmol/l (was 5.7 ? 0.5
- 2 h OGTT plasma glucose was 10.3 ? 1.0 mmol/l (no 8-week figure given)

Three participants had recurrence of diabetes as judged by a 2 h post-load plasma glucose >11.1 mmol/l. F

 

[Northerner]

...- 2 h OGTT plasma glucose was 10.3 ? 1.0 mmol/l (no 8-week figure given)

Three participants had recurrence of diabetes as judged by a 2 h post-load plasma glucose >11.1 mmol/l. F

So if the OGTT was plus or minus 1, then it could have been 11.3? Not that short of diabetic at 11.8? And with such a small sample of participants how reliable are the numbers?

Whilst the findings about the increased insulin production are really good I think it is a huge leap to start talking about having cured Type 2 diabetes, as many/most of the reports have been doing. Having such an extreme diet for so long is bound to affect the body in many ways - there are many examples of ways that we can have a quite sustained impact on the way our bodies work by treating it in an extreme way, and I would think it was far too early to suggest that the benefits would be maintained indefinitely.

It seems that every tiny new finding, in whatever area of health it occurs, these days is blown up out of all proportion. Maybe, eventually, the public will get so used to hearing these health scares/wonder cures that they will just start ignoring them as works of fiction, especially as most of them appear to be headlines today and either gone, disproved or contradicted the next. 🙄

 

[Jill]

Help, I thought Wiki would explain but that explanation is very chemical.
http://en.wikipedia.org/wiki/Fatty_acid_metabolism

Basically, in this case these are fatty acids in bloodstream.
When fat in the form of triglycerides, is broken down it forms glycerol and 3 molecules of fatty acid. (hence the name) These can be used in various ways to provide needed energy. They can also recombine and be stored in the liver and fat cells, to be broken up again. Your stored fat doesn't just sit there doing nothing!
Elevated levels of FFAs are linked with insulin resistance.(and why they might be elevated is another essay ) but it's noticeable that in this study they rose initially, then fell and then fell even more in the 12 weeks after the diet.

Oh my brain hurts!

 

[AlisonM]

I suspect there are as many ways of developing T2 as there are T2s. Some folk's systems may kick back in if they give it a shock such as this diet, but what happens when the shock wears off? I'd be interested to see how all of these folk are doing ten years from now. Any bets on how many of them will have re-acquired the diabetes?

 

[HelenM]

A review of the study on the NHS site
http://www.nhs.uk/news/2011/06June/Pages/type-2-diabetes-and-low-calorie-diets.aspx

 

[Northerner]

A review of the study on the NHS site
http://www.nhs.uk/news/2011/06June/Pages/type-2-diabetes-and-low-calorie-diets.aspx

An excellent assessment, and reveals just how wrong and misleading the headlines were. Not a cure, or even (at this stage) a feasible treatment for the millions of people with diabetes. The fact that several of our members here have related how friends and relatives have interpreted the story shows just how the message has come across to the general public. Even DUK themselves are guilty of implying this message in the opening paragraph of their website story on the subject:

Research funded by Diabetes UK and carried out by a team from Newcastle University has discovered that Type 2 diabetes can be reversed by an extremely low-calorie diet alone.

http://www.diabetes.org.uk/About_us/News_Landing_Page/Can-diet-alone-reverse-Type-2-diabetes/

What seems to be missing is the fact that, whilst some beta cell function may have been restored, there is no knowledge of how long it will take for the subject's pancreas to become under stress again and start to fail - would the diet need repeating? We all know the dangers of crash/yo-yo dieting. No-one should be able to get away with calling this a 'cure'. I wonder how many people will think that, whilst they may be in danger of getting Type 2 diabetes, it's no big deal because they can cure it by making a bit of effort for 8 weeks?

 

[FM001]

One of the reasons why I don't get excited anymore when I see a headline - Diabetic Cure

 

[Northerner]

One of the reasons why I don't get excited anymore when I see a headline - Diabetic Cure

I can imagine toby - you've seen a lot more of them than me!

 

[wallycorker]

Dear wally,

Nice to see you posting again, how are you doing? Just an additional thought: My last HDL was 1.6mmol/L and my last Trigs were 0.8mmol/L and I eat a very high fat diet. Does it not seem feasible that our excellent figures are due to low carb? The excellent results seen in this trial, are probably, as Northerner observed, due to the low carb also.

Warmest Regards Dodger

Hi Dodger,

I'm absolutely fine thanks.

Despite the impression that many people have of how I eat, I can't ever say that I've been what people understand to be low-carb - i.e. 40/60g of carbohydrate per day. I've always eaten far too much fruit for that to be the case.

I say that I've been eating a lowish fat (very low at times but not these days) and a low starchy carbohydrate diet.

I agree entirely, I am sure that reducing carbohydrate significantly played a very significant effect on improving my triglyceride and HDL numbers. In my opinion, it is the TG/HDL ratio that matters most - whatever it is that reduces that is the most important thing.

As I have said previously, the important thing about the work at Newcastle University isn't the actual diet used for the study. In my opinion and I think that of Professor Taylor also. it is the fact that the Type 2 situation need not be necessarily progressive as we have all been told many times - it is that the process can be reversed.

Best wishes - John

 

[FM001]

I can imagine toby - you've seen a lot more of them than me!

Far to many to recall, I hated diabetes with a vengeance in my younger days and always got my hopes built up when reading Diabetes Cure headlines, my poor consultant must have got sick of me asking if there was any truth in these stories😱

Despite the impression that many people have of how I eat, I can't ever say that I've been what people understand to be low-carb - i.e. 40/60g of carbohydrate per day. I've always eaten far too much fruit for that to be the case.

I say that I've been eating a lowish fat (very low at times but not these days) and a low starchy carbohydrate diet.

I agree entirely, I am sure that reducing carbohydrate significantly played a very significant effect on improving my triglyceride and HDL numbers. In my opinion, it is the TG/HDL ratio that matters most - whatever it is that reduces that is the most important thing.

Always read your posts with interest Wallycorker, my recollection is that you stated that you ate on average 130g of carbohydrate a day mainly consisting of fruit and low fat foods, such a healthy diet would only serve to promote good cholesterol levels as you are achieving now, fruit has many health benefits one of which is protecting the heart against cardiovascular disease.

 

[Ellowyne]

I might give this a go?

Having read the article, which states the drastic diet is for '8' weeks, as opposed to what I had previously read...6 months?

If the 8 weeks of 600 calories is correct, and then going on to a portioned controled healthy diet, then I might just give this a go...Of course, I will speak to my Dr first and get the go ahead.

But for me, it may be a last option...I can not excercise and, for , Insulin has made it difficult for me to lose weight and,well, I have gained alot of weight in the process. Apart from this, I am desperate to get to a weight where they would be willing to remove this god awful Gall baldder of mine...I was in Hospital again last week...Liver function at 226!

It is ok for thoses that can excercise and go for a walk ect...But I find just the walk aroung the supermarket exhausting and I suffer with Chronic pain all the time...Perhaps, if I can find the Will power, perhaps this could work for me?

I will let you know what my Dr says...and, if I do embark on this, then I would dearly love some support here...I think I would need it!

Hope you are all keeping well, love Ellowyne xXx

 

[Northerner]

Hi Ellowyne, I don't think that this is something that would be approved, except as part of a research project, as this was. It is wrong of all the papers to start talking about a cure and getting people's hopes up when the treatment is not fully proven, to say nothing of knowing whether it is safe long term.

By all means ask your GP whether he thinks it is feasible, or he may be able to suggest something more appropriate, and your enquiry may spark some possibilities when he sees how determined you are.

 

[bev]

Hi Ellowyne,

Reducing your calorie intake is worth a try if you really want to lose weight - I suppose it depends on how much your daily intake is now and whether this is drastic in comparison. Perhaps your GP might set a slightly higher target to see what effect that may have to begin with. I am sure you would get support if you made the decision to try it.🙂Bev

 

[Northerner]

This diet is drastic by anyone's standards bev, it's a starvation diet that needs everything that is eaten or drunk to be carefully prepared for the individual in order to meet their own personal nutritional needs. Even when being closely monitored several of the study participants dropped out and of the remaining 11, 4 showed no benefit. Of those that did there is no data about whether the beneficial effects will actually last, or if participating has caused any other damage - such an extreme diet can cause damage to the heart as muscle protein is used to fuel the body.

Really, it's an interesting observation that can be the basis of future study, it is not a feasible cure right now.