Study finds low-calorie diet and weight loss could reverse condition for some patients. By Tan Weizhen
Any weight loss is beneficial in the management of diabetes, even if the patient does not achieve a cure, says endocrinologist Peter Eng. Photo: Jennifer Barrow / www.123rf.com
Despite popular belief, getting a diabetes diagnosis does not necessarily mean a lifetime of medication.
Recent research showed that going on a very low-calorie diet could reverse the condition for some.
Researchers from Newcastle University in Britain put 30 people with Type 2 diabetes on a 700-calorie diet a day for eight weeks. Each person lost about 14kg on average. For many, their diabetes disappeared.
What’s more, the effects of the diet did not. Almost half of them did not have any symptoms of diabetes for nearly six months after they gradually went back to having a more normal diet which helped them to maintain their weight loss.
The results of the study were published in Diabetes Care earlier this year.
Doctors who Mind&Body spoke to said that while it is known that diabetes can be reversed with weight loss for some people, the challenge for many is to maintain a healthy body weight.
In some patients, Type 2 diabetes can be reversed after a substantial weight loss which usually happens after a persistent low-calorie diet for months, said Dr Nitish Mishra, a consultant at the Raffles Diabetes & Endocrine Centre.
He explained that one of the important causes of Type 2 diabetes is having too much fat in the liver and pancreas.
“Every individual has a personal fat threshold and once they cross that, Type 2 diabetes develops,” he said.
Hence, following the same principle, once they successfully lose weight and go below their personal fat threshold, the diabetes will disappear, he added.
Endocrinologist Peter Eng, of Peter Eng Endocrine Clinic, said most patients do not achieve a cure. Those who tend to be cured are either obese or very obese and are able to lose a significant amount – at least 20 per cent – of their weight.
Eat whole grains, limit red meat
They would also have to maintain their weight loss. Once they gain back the weight, diabetes returns.
The patients for whom the chances of this approach working are very small tend to be those who have had diabetes for many years, said Dr Eng.
This is because their insulin reserves would have diminished over the years, compared with someone who has had diabetes for a shorter time.
However, any weight loss is beneficial in the management of diabetes, even without a cure, said Dr Eng.
And what you eat has an impact.
Dr Mishra cited a study where researchers looked at the whole-grain consumption of more than 160,000 women, whose health and dietary habits were followed for up to 18 years. It found that women who averaged two to three servings of whole grains a day were 30 per cent less likely to develop Type 2 diabetes than those who rarely ate whole grains.
The bran and fibre in whole grains make it more difficult for digestive enzymes to break down the starch into glucose, he said.
This leads to lower, slower increases in blood sugar and insulin, and a lower glycaemic index. As a result, they stress the body’s insulin making machinery less, and so may help prevent Type 2 diabetes.
He also advised limiting red meat, and choosing chicken and fish instead, citing studies that found eating one 85g serving of red meat a day increased the risk of Type 2 diabetes by 20 per cent.
Some, like American physician Neal Barnard, who has written books on nutrition, advocate a more extreme diet.
Dr Barnard recommends a low-fat vegan diet for those trying to reverse their conditions. Vegans are vegetarians who also do not eat animal by-products such as eggs and dairy items.
But doctors also say that achieving weight loss does not mean patients should stop taking their diabetes drugs as well as insulin injections all at once.
Dr Barnard said: “Everyone will start and finish at different points. One patient may be able to get off insulin and toss his or her medications within a month. For others, it might take a year or longer.”
Dr Mishra said it is a slow, gradual process of reducing dosage in a timely manner, and it must be done under the supervision of doctors.
And no matter which diet one chooses, the take-home message should be that the total calorie intake is still more important than any specific type of diet, said Dr Eng.
On a bigger scale, diabetes prevention is ultimately about health policies and strategies to reduce the prevalence of obesity in a population, he said.
A version of this article appeared in the print edition of The Straits Times on May 10, 2016, with the headline ‘Have Type 2 diabetes? Don’t lose hope’.