Diabetes Remission by Losing Weight

Patient Expert

A very low-carbohydrate diet is the usual way to put your type 2 diabetes into remission. But it’s not the only way.

Source: Blausen.com staff. "Blausen gallery 2014.0" Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762.

Two small studies by researchers at the UK’s Newcastle University show that eating an extremely low-calorie diet for a few weeks can also work. While this is generally known as the 600-calorie diet, that’s not the point. The way that it works, the researchers say, is that when we lose a substantial amount of weight, we get rid of the fat that surrounds our liver, and this restores our liver insulin sensitivity and beta-cell insulin secretion.

The studies show remission

The first of these studies, “Reversal of type 2 diabetes,” came out in a 2011 issue of Diabetologia, the official journal of the European Association for the Study of Diabetes.

The researchers studied eleven people with type 2 diabetes for eight weeks on a diet of 600 calories per day, matching them with eight people without diabetes. “The sample size was necessarily small to allow for the application of gold standard methods,” the study says. It concluded that both beta cell function and liver insulin sensitivity “was achieved by dietary energy restriction alone.”

This initial study was limited to people who had diabetes for less than four years. But a follow-up study of 14 people who had type 2 diabetes for more than eight years will soon be published in Diabetic Medicine, the official journal of Diabetes UK. With an average duration of 13 years of diabetes, the people in this group had a 50 percent chance of getting down to non-diabetic fasting blood sugar levels without any diabetes medication. While only the abstract of this  study is available online in advance of print at “Restoring normoglycaemia,” Dr. Roy Taylor, the lead author, sent me a copy of the full-text.

Lose lots of weight

You have to be “strongly motivated to escape from diabetes” in order to lose enough weight, Dr. Taylor admits in another article, “Type 2 Diabetes,” published in the April 2013 issue of Diabetes Care, a professional journal of the American Diabetes Association. But “substantial weight loss in entirely possible by decreasing food consumption.”

Our doctors and nurses generally tell us to lose 10 percent of our body weight. Twenty-one years ago, when I weighed 292 pounds, the dietician, who was there to help me manage my diabetes, told me that. So my goal then was to get down to 261 pounds. That did improve my blood sugar control. But it didn’t make my pancreatic function normal, and now that my weight today is 156 pounds, my diabetes is in remission, which I think is better than a cure.

Dr. Taylor and I agree. “The extent of weight loss required to reverse type 2 diabetes,” he writes, “is much greater than conventionally advised.”

Free your liver

People with diabetes typically have to lose a lot of weight to free their liver. Almost all of us have livers clogged with fat, because that’s where our excess calories go first. One study of 2,938 people with type 2 diabetes, “Prevalence of nonalcoholic Fatty Liver Disease,” found that 70 percent of us have fatty liver.

The medical establishment is wrong to say that type 2 diabetes is “inevitably progressive,” Dr. Taylor writes. We can instead reverse it “by the single cause” of freeing our fat.

See more of my articles about how to manage diabetes:

Fatty Liver and Exercise

Diabetes, Obesity, Nonalcoholic Fatty Liver Disease, Walking 60 Minutes Weekly

When Remission Is Better Than a Cure for Diabetes

Is Diabetes Progressive?

Diabetes Causes Nothing