Weight And Body Fat Decrease Led To Remission
For ReTUNE, the team recruited 20 individuals with type 2 diabetes of less than 6 year’s duration who had a BMI of 21-27 kg/m2 and compared them with 20 matched controls, with a follow-up of 52 weeks.
Patients were an average age of 59.0 years, 13 were women, mean BMI was 24.8 kg/m2, and average duration of diabetes was 2.8 years. Mean A1c was 54 mmol/mol.
Fourteen of the patients were taking metformin at enrollment and two were being treated with gliclazide. These medications were stopped when the individuals with type 2 diabetes entered a weight loss program incremented in 5% steps, followed by 6 weeks of weight stability.
Overall, weight decreased by an average of 9%, while body fat decreased from 32% at baseline to 28% at 1 year , the same percentage as that seen in the controls.
Liver fats also decreased significantly from baseline down to approximately the same level as controls at 1 year, a pattern also seen with very low-density lipoprotein cholesterol and triglyceride levels.
Pancreatic fat decreased steadily and significantly over the course of the 52-week follow-up , although remained above the level seen in controls.
Insulin secretion increased significantly over the course of the study to finish just over the threshold for the lower range of normal at 52 weeks.
This, Taylor showed, was enough for the 14 patients who achieved type 2 diabetes remission to see their A1c levels fall significantly during follow-up , alongside fasting plasma glucose levels .
How Can Diabetes Cause Weight Loss
Unexpected or unintended weight loss is often a symptom of unmanaged diabetes, both type 1 and type 2.
With type 1 diabetes, the immune system attacks cells of the pancreas that make insulin. Since theres no insulin available to move glucose into the bodys cells, glucose builds up in the bloodstream. The kidneys then work to remove this unused sugar through urination. The sugar isnt used as energy, so the body starts burning fat and muscle for energy, resulting in weight loss.
Weight loss in type 1 diabetes may be unintentional. If people with type 1 diabetes need to lose weight, this can be done safely by reducing calorie intake. Some people may under-treat their diabetes to lose weight, but this is highly dangerous. Skipping insulin can lead to very high blood sugar levels, a serious complication known as diabetic ketoacidosis, and potentially death.
Under-treating diabetes to lose weight can be a symptom of an eating disorder. If you think you have an eating disorder, reach out to your doctor or a mental health professional to get specialized support and treatment.
Weight Loss In Children
Unexplained weight loss can occur in people who have type 2 diabetes, but its more common in people with type 1. Type 1 diabetes usually affects children and adolescents. Parents are often the first to notice an unusual weight loss in a child with type 1 diabetes.
Weight loss in kids with diabetes can occur even in those who have a normal or increased appetite for the same reasons it happens in adults with diabetes. Once kids are diagnosed and treated for diabetes, weight loss ceases and typically returns to normal.
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How Can I Put My Diabetes Into Remission
- People who completed the Counterweight-Plus programme lost an average of 10kg, whereas people who received standard NHS treatment only lost an average of 1kg
- Around ¾ of people who lost at least 10kg through the Counterweight-Plus programme achieved diabetes remission
- Half of the people that followed the Counterweight-Plus programme were successful in stopping their diabetes medication
- 9/10 people who were able to lose 15kg or more achieved diabetes remission, indicating that the more weight that you are able to lose, the more likely you are to put your diabetes into remission
Us Diabetes Expert Endorses Findings: T2d Can Be Reversed
This most recent analysis reflects expert opinion not only in the UK but also among experts in the US and elsewhere, says Domenico Accili, MD, Russell Berrie Foundation Professor of Diabetes at Columbia University School of Medicine in New York City. He was not involved in the Taylor study but has conducted researched on beta cells and diabetes.4
Dr. Taylor said diabetes researchers have been discussing the probability that the insulin-producing beta cells in patients with type 2 diabetes may not be dead, just dormant and that achieving a 10-15% weight loss seems sufficient to reactivate them.
Recent research by Dr. Taylor and others, Dr. Accili says, suggests that ”maybe there is more room for lifestyle modification than we previously thought,” and it just may have a bigger effect than was realized.
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How Your Weight Influences Your Diabetes
The most common cause of type 2 diabetes is insulin resistance. This occurs when the cells of your body no longer respond to the hormone insulin.
Normally, insulin signals your cells to absorb glucose from the bloodstream. Glucose is your bodys main form of energy. When cells become resistant to insulin, glucose remains in the bloodstream, and your cells are starved for energy.
If left untreated, insulin resistance can progress to type 2 diabetes. Being overweight or obese is a risk factor for insulin resistance and diabetes, as well as heart disease and many other health conditions.
Here’s How Healthier Habits May Help Some People Reverse Or Better Manage The Disease
Diabetes is a very common but serious medical condition. According to the Centers for Disease Control and Prevention , more than 34 million Americans have it, with about 90-95% of them having type 2 diabetes. About 88 million people have prediabetes, a precursor to type 2 diabetes.
There is no cure for type 2 diabetes. But it may be possible to reverse the condition to a point where you do not need medication to manage it and your body does not suffer ill effects from having blood sugar levels that are too high.
Making positive lifestyle changes such as eating a well-balanced diet, exercising regularly and getting down to a healthy weight are the key to possibly reversing or managing type 2 diabetes. Other lifestyle changes may also help, including not smoking, getting enough sleep, limiting alcohol and managing stress. However, for some people this is still not enough and medication is needed to manage the condition.
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Type 2 Diabetes In Remission
And after one year, 46% of those in the intervention group were able to achieve remission of type 2 diabetes. Only 4% in the control group did.
Remission was defined as achieving an HbA1c that was less than 6.5% without the use of medication for a minimum of 2 months.
Among those in the low-calorie intervention group, nearly a quarter shed 33 pounds or more, which was the studys primary goal. None in the control group achieved such a weight loss.
Lose Weight Reverse Type 2 Diabetes: Why It Works
Sept. 17, 2018 — Peter Maher, a retired teacher in London, says weight has been a long-term issue for him. But when it inched up even more a few years ago, his type 2 diabetes became more unmanageable. Soon after the scale read 245 pounds, he remembers catching a glimpse of himself in a mirror.
“I saw this great, fat person staring back at me,” recalls Maher, now 71. “That was my eureka moment.” Knowing he had to take action, he consulted âDr. Google.â
He found a London doctor who had published research about how substantial weight loss can reverse type 2 diabetes. In late 2015, he emailed Roy Taylor, MD, at Newcastle University and said he’d like to go on the plan Taylor had devised. The response? “You and 20,000 others.”
Taylor’s plan was so popular, he could take on no more people. Maher persisted, so Taylor sent him detailed directions and the protocol — a strict liquid diet of 800 calories at first, with regular food then phased in. The liquid diet consists of four servings of soup or vitamin-rich shakes.
By September 2016, after months of dieting, Maher had lost 66 pounds and was able to go off all his diabetes medicines, including insulin. His general practitioner said he had truly resolved his diabetes. And he had had the disease for about 30 years.
Now, he is one of Taylor’s poster patients — he’s kept off most of the weight and still does not need insulin or other diabetes medicines.
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Keep Track Of Your Goals And Progress
Writing down the details of your weight loss journey helps you set healthy targets and notice patterns. Youll be able to appreciate your progress over time, as well as notice when your diet might have gotten a bit off track.
Try jotting down all of the foods you eat, including the serving sizes, in a journal every day. Not a fan of pen and paper? Try one of the many free apps. Its a good idea to weigh yourself at least once a week, per your doctors or diabetes educators recommendation, to keep track of your progress. You might also want to write down when you exercised, what you did, and how you felt after.
Weight Loss First Line Of Treatment
These findings support the theory of a personal fat threshold, above which “type 2 diabetes occurs,” said Taylor. “Weight loss is the first-line treatment for all with type 2 diabetes, irrespective of BMI.”
Taylor already showed in the DiRECT trial that a calorie-restricted liquid diet followed by gradual food reintroduction and a weight loss maintenance program can achieve and sustain type 2 diabetes remission at 2 years in people who are overweight or obese.
As reported by Medscape Medical News, 36% of 300 patients enrolled in the trial attained diabetes remission and maintained it out to 24 months, compared with negligible changes in the control group.
Inspired by the results of DiRECT and the DROPLET study, the National Health Service in England has been rolling out a low calorie-diet treatment program for people who are overweight and living with diabetes.
Asked during the post-presentation discussion whether the current results could have implications for the NHS program, Taylor said it remains, in effect, a study and will not change things for now.
Chris Askew, chief executive of Diabetes UK, said in a release: “This game-changing study…advances our understanding of why type 2 diabetes develops and what can be done to treat it.”
“Our ambition is for as many people as possible to have the chance to put their type 2 diabetes into remission and live well for longer.”
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How Much Weight Do I Have To Lose To Lower My Risk Of Diabetes
If you are pre-diabetic or diabetic, then losing 5-10 percent of your body weight can help improve your blood sugar numbers. If you are pre-diabetic and can lose this weight, you will lower your risk of developing diabetes by 58 percent.
In addition to helping you lose weight, exercise can improve your blood sugar numbers. Learn more about our weight loss services, as well as management of metabolic disorders.
Type 2 Diabetes Remission Possible For Those With Lower Bmi
A weight loss program can lead to type 2 diabetes remission, even in individuals with a normal body mass index , via loss of body fat, particularly in the liver and pancreas, shows a UK study.
The ReTUNE trial, funded by Diabetes UK, involved 20 people with type 2 diabetes of less than 6 year’s duration and a BMI of 27 kg/m2 or lower.
After 1 year, participants had lost 9% of their body weight.
Their body fat decreased significantly, to the same level as controls without type 2 diabetes, and they experienced decreases in liver fat, total triglycerides, and pancreatic fat.
The research, presented at the Diabetes UK Professional Conference 2022 on April 1, also showed this was accompanied by increases in insulin secretion and reductions in A1c and fasting plasma glucose levels.
Lead author Roy Taylor, MD, PhD, professor of medicine and metabolism, Newcastle University, Newcastle upon Tyne, UK, said the findings indicate that the “etiology and pathophysiology of type 2 diabetes is the same whether BMI is normal or raised.”
This information should make a profound difference in what doctors advise their patients, Taylor added.
“One of the dramatic things about dealing with people in this group,” he said, “is they feel very resentful that healthcare professionals tell them not to lose weight.”
Based on the current results, Taylor believes this is “inappropriate advice, and it’s that personal advice that I think that this study points a way towards.”
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Getting Blood Sugar Back To Normal
The good news: When we shed the body fat, insulin often starts working again. Thats because our bodys cells often start working again. Their doors kick open when insulin comes calling. Once again, insulin can ferry glucose out of the bloodstream and into our cells. As a result, blood glucose falls into healthy, normal ranges.
Schedule Your Meals Including Breakfast
A common characteristic among the NWCR participants is that most of them ate breakfast. Skipping breakfast is thought to possibly lead to overeating later in the day, which can sabotage weight loss plans and cause blood sugar levels to fluctuate. People who eat breakfast may also have more energy to stay more active throughout the day.
The importance of a morning meal for weight loss has been debated. One meta-analysis published in September 2014 in Advances in Nutrition showed that eating breakfast was associated with better weight loss, but another review of studies, published in January 2019 in BMJ, found that breakfast may not always lead to weight loss. Still, the ADA recommends eating breakfast every day. Experts say an effective diabetes diet involves eating three meals at regular times of the day to help the body better use insulin.
Breakfast should include fiber-rich, healthy carbohydrates, such as whole grains, fruits, and low-fat dairy, to help keep blood sugar levels in check. Always review labels before you buy packaged foods, and skip cereals and other breakfast foods with added sugar.
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Use Tricks To Prevent Overeating
These sneaky strategies can help keep you from overdoing it on diet-damaging foods.
- Fill up on low-calorie foods first. Start every meal with the foods on your plate that are lowest in calories, suggests McLaughlin. Non-starchy vegetables make the perfect low-calorie starter. By the time you get to the other foods, you wont be so hungry.
- Change your salad dressing system. Instead of sprinkling or pouring dressing on your salad, dip your fork into a side dish of dressing and then your salad with each bite. Youll be amazed how much less you use and how many calories you save.
- Take up a busy-hands hobby. If youre idle, youll be more prone to eating when youre not really hungry. Keep busy with activities like walking, knitting, scrapbooking, doing crossword puzzles, or gardening.
- Carry a toothbrush and toothpaste. Keep them in your purse or briefcase. When cravings hit, brushing your teeth with peppermint-flavored toothpaste can dampen your desire to eat.
- Arrive fashionably late to parties. Without as much time near the buffet table and calorie-rich appetizers, youll likely eat less.
Its important to continue to eat healthy and exercise regularly even after reaching your weight loss goal. Thats why its so important to set realistic goals from the get-go: The healthy habits you initiate to lose weight should last a lifetime so you can keep it off.
Additional reporting by Colleen de Bellefonds
How Do We Achieve Remission
Significant weight loss appears to be the most effective way to achieve type 2 diabetes remission. Professor Roy Taylor, a leading researcher of type 2 diabetes, and colleagues at Newcastle University conducted the first ever dietary and lifestyle intervention trial with remission as the primary endpoint. This was called the DiRECT study. 320 participants, all diagnosed with type 2 diabetes within the last 6 years, were randomised into either the intervention group or the control group.
The intervention was a very low-calorie diet programme. Participants dramatically reduced energy intake to 850 calories a day and then were slowly reintroduced to a regular, healthy diet to maintain weight loss. The control group received the usual current treatment on the NHS for type 2 diabetes.
This study is ongoing, but so far the results have demonstrated that after 1 year, those in the intervention group lost significantly more body weight compared to the control group . In addition, 46% of the intervention group went into remission, compared to only 4% in the control group.
At 2 years, 36% of those who began the trial in the intervention group were in remission as opposed to 3% of those in the control group.
These results suggest that significant weight loss can reverse type 2 diabetes and result in regular insulin activity for some, even if the individual has been diagnosed up to 10 years ago.
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Do You Need To Lose Weight
Not everyone with Type 2 diabetes is overweight millions have a healthy body mass index . But BMI is not a very reliable measure, because the amount of excess fat you have on your body may be less significant than the kind of fat.
Much research indicates that it is abdominal fat, especially the fatty deposits around the liver and pancreas, that inhibit insulin secretion. This is the fat that helps to cause and exacerbate type 2 diabetes.
The simplest way to measure your abdominal fat is to calculate your waist-to-height ratio. A high waist-to-height ratio is a much more reliable sign of poor metabolic health than a high BMI. There are millions of adults with so-called skinny fat bodies they may look lean, and have normal BMIs, but they carry too much of that dangerous fat around the vital organs.
If you are truly lean, both abdominally and elsewhere, you may benefit more from building muscle than from losing fat.