Weight loss has long been prescribed for people with type 2 diabetes to help improve their quality of life, but new research suggests that significant weight loss has the power to reverse the disease altogether.
A recent study published in the medical journal The Lancet found that significant weight loss — 33 pounds or more — can reverse type 2 diabetes.
The United Kingdom-based Diabetes Remission Clinical Trial (DIRECT) followed type 2 diabetics age 20-65 who were not taking insulin and had a body mass index of 27-45 for a year. Participants followed a strict 825-850 calorie diet for the first three to five months and were encouraged to maintain regular exercise, increasing to 15,000 steps in the second phase of the trial. At the 12-month mark, almost half the participants achieved remission to a non-diabetic state and were able to stop anti-diabetic drugs. Nine out of 10 individuals who lost 33 pounds or more, and over half of those who lost 22 pounds, achieved this goal.
Vanessa Arguello, M.D., an endocrinologist and diabetes specialist at University of California, Los Angeles Medical Center, finds the results eye-opening.
“Traditionally, we recommend a five- to seven-percent weight loss, but for these participants it was 15 percent, which is very aggressive and difficult to do,” she said in a telephone interview with HealthCentral. “But it shows how important weight management is in controlling chronic conditions like diabetes.”
Dr. Arguello explains why: “Excess fat in the body can deposit into different organs: the pancreas, the liver, and the muscles, and lead to insulin resistance, especially around the belly. Having fat in those organs can decrease our ability to use insulin. But people who have been diagnosed in the last six years and have good pancreatic function — making their own insulin — who have a 15 percent weight loss and maintain it, should be able to go into remission.”
Dr. Arguello recommends a diet that restricts carbohydrates and added sugars, limiting the latter to less than 25 grams per day for females and 35 grams per day for males, and making sure those carbs are the complex variety found in vegetables and whole grains. “I tell patients to look at the Mediterranean, Zone, and Paleo diets,” she said.
Although there wasn’t a great emphasis on exercise, at least in the first phase of the DIRECT study, Dr. Arguello stresses its importance in achieving a weight-loss goal.
“In type 2 diabetics, activity is very important because it improves insulin sensitivity — the body’s ability to use its own insulin more efficiently — and reduce the need for medication,” she said.
Dr. Arguello recommends following the American Diabetes Association guidelines for physical activity: 150 minutes of aerobic exercise a week and three strength-training sessions per week.
“Multiple studies have shown that the combination of strength training and cardio is important. Cardio reduces mortality and improves insulin sensitivity, and strength training changes your body composition. Muscle burns more calories than fat and helps you maintain weight loss. The more muscle you have, the more fat you’re able to burn.”
She suggests that older individuals use three- to 15-pound weights, and younger people try “as much as you can lift.” She encourages her patients to use step counters and download smart phone apps that will help them to reach a 10,000-step goal. “It’s important to move daily.”
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Gerri Miller is a veteran lifestyle and entertainment journalist who has contributed to a variety of print and web outlets, including Glamour, People.com, MNN.com, Lupus Now, and Muscle & Fitness and currently writes for the Jewish Journal, Brain World, FromtheGrapevine.com, and ScienceNewsForStudents.com. With roots in New York but happily living in Los Angeles since 1993, she’s a former Jeopardy! champion and plays Scrabble online every day.