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In 2013 Diabetes UK awarded the largest ever research grant in the charitys 79year history to support a new five-year study.
Professor Roy Taylor at Newcastle University and Professor Mike Lean at the
University of Glasgow will draw on over 2.4 million and work in partnership to
compare the long-term effects of a new approach to weight management with
the best diabetes care that is currently available.
The aim is to find out if this intensive weight management plan is the best way
to help people with Type 2 diabetes become non-diabetic and remain that way.
The new research
What is the background to this research?
Weight gain and obesity are the most important risk factors for Type 2 diabetes
and the reason why Type 2 has become a global epidemic that affects
overweight people of all ages.
Surgical operations, such as gastric banding and gastric bypass, are potential
solutions because they lead to dramatic weight loss, which can put Type 2 into
remission for up to 80% of patients. Such treatments; however, are expensive,
invasive and carry a risk of surgical complications, all of which mean they can
only be offered as a last resort to people who are dangerously obese.
Low-calorie diet foods are not available on prescription from the NHS. They are
marketed by a range of private companies, but can be expensive and come with
limited evidence of long-term benefit. This research is the only way to tell if
weight management using a low-calorie liquid diet is practical and more effective
than the current best-available treatment for Type 2 diabetes.
Should people with Type 2 diabetes follow the diet used in this study?
Until we have evidence that low-calorie liquid diets are more effective at putting
Type 2 diabetes into remission than the current best-available treatment,
Diabetes UK does not yet recommend that people with Type 2 diabetes attempt
to lose weight in this way. The charity is confident that the new study will answer
our questions and so give the NHS enough evidence to make a decision on
whether low-calorie diets should be offered as a routine treatment option. People
with diabetes should always consult their GP before making changes to the way
that they manage their condition.
What diet does Diabetes UK recommend for people with Type 2?
Diabetes UK recommends that people with Type 2 diabetes eat a healthy
balanced diet that is low in sugar, salt and fat and high in fruit and vegetables.
For information on living a healthy lifestyle and eating well with Type 2 diabetes
please see our guide to diabetes.
More...
Me and my operation: The laser gun that burns away floaters from
your vision
The diet involved eating just 800 calories a day compared to a man's
recommended intake is 2,500
The first full day, a Sunday, I woke with no decent breakfast to look
forward to just some watery shake. (The meal-replacement shakes
from the shops work fine I used The Biggest Loser brand, but there
are many available.)
After just one day my glucose levels had dropped from 6mmol/l to
5.9mmol/l. Hunger was never far away. But Professor Taylor said that
the hunger pangs were something to celebrate, as it meant that the
diet was working.
Toast yourself with water, he said, and the hunger will disappear. And it
worked: I downed a pint of water and the hunger went.
The weight came off fast. By day three I had already lost 2lb.
Day four saw my glucose level plummet from 5.9mmol/l on the Sunday
to 4.6mmol/l. I even started to get used to the idea of a shake for
breakfast: thoughts of fresh crusty bread went out of the window. I was
training my mind to reduce my choices and yet value the options
remaining.
Lunch was my own delicious, thick mushroom soup (I blended
mushrooms, onions, veg stock and herbs together), washed down with
a cherry-flavoured shake. I gulped down a chicken soup supplement
before leaving the office to see a play in the evening. Concentration
levels were fine, but climbing up my local Tube station stairs afterwards
was a real slog. I felt tired and lethargic.
The pattern continued each day. I experimented with more soups such
as carrot, tomato and pea, baked veg, stir-fried veg, boiled veg and
casseroles, liberally seasoned with herbs Id never used before, such as
cumin and paprika.
Some mornings I walked to work fine, others I was in a bit of a daze,
and on certain days walking round the office was an effort. My family
were concerned about me getting thinner and somewhat shorttempered.
Day six was a bad day. Despite it being mid July, I wore four layers of
clothing to keep warm and even then my fingers grew numb. I felt
tired in the evening, and then constipation set in. Perhaps it was
because I was not drinking enough water. Laxatives saved the day and
the following morning I recorded my lowest overnight fasting glucose
reading 4.3mmol/l a real boost.
On day eight I played cricket and it was hard watching teammates
stuffing themselves with doughnuts. I had to toast a century-scoring
colleague with water.
Three days on, I was down to 8st 13lb with my glucose level down to 4.1
mmol/l.
But I could not ignore concerned comments at work about my
shrinking. Some of my clothes no longer fit me, and even I was slightly
alarmed about how thin I had got in the face.
I was known as the disappearing man by colleagues. It was time to
stop the diet. (I then returned to a healthy wholegrain diet comprising
lots of fruit and veg, chicken, fish and non-fatty foods).
Two months later, I got myself tested at the surgery to register a
healthy, non-diabetic 5.1mmol/l and was elated when my GP told me:
Your diabetes has resolved itself.
I had stuck to the diet for just 11 days, and reduced my blood sugar to a
healthy non-diabetic level. It has remained that way for the past year
my latest reading was 4.9mmol/l. I have kept to just under 9st, joined a
gym and gone running three times a week.
On Professor Taylors advice, I have also started building up my upper
body muscle: bigger muscles soak up more glucose as energy, and thus
prevent the body from storing more than it needs.
Professor Taylor started investigating the diet after he became
intrigued by the observation that type 2 diabetes is reversed almost
overnight in obese patients following gastric bypass surgery for weight
loss.
The surgeons explanation was that it was something clever to do with
gut hormones, which help control our appetite, but this was clearly
unsatisfactory.
Professor Taylor instead focused on the fact that patients were unable
to eat much in the days following the surgery, and wondered if this
could in fact be responsible for reversing diabetes.
I realised that this led to a sudden shift of fat away from the liver and
pancreas. I thought we could test this by taking people with type 2
diabetes and mimicking the very sharp reduction in food intake after
surgery.
I predicted this could strip fat out of the liver and pancreas and both
organs would return to normal and our subsequent work has
confirmed this.
And the work continues. Alan Tutty, 54, from Seaburn Dene,
Sunderland, is one of 34 volunteers in Newcastle Universitys second
trial looking at longer term effects of the diet. In eight weeks between
last November and January, he, too, successfully reversed his type 2
diabetes, shedding 26lb to reach his target weight of 13st 3lb.
Since coming off the diet, my weight has occasionally risen to 13st 9lb,
but its always crept back down to 13st 5lb, he says.
The approach has been met with excitement by other experts in the
field. James Walker, consultant diabetologist at Livingston hospital,
West Lothian, believes the research challenged conventional thinking.
A lot of people have perhaps too simplistically thought that once the
pancreas starts to fail, and stop producing insulin, it is an inevitable
decline. But this diet challenges that.
And what is brilliant is that it works so quickly. Weve even produced a
little diet booklet in West Lothian for patients mainly nicking Roys
ideas.