Radical Diet Reverses Type 2 Diabetes, But For How Long?

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A new study confirms that a radical low-calorie diet can reverse Type 2 diabetes. Most subjects reduced their HbA1c level below the diabetic range, without medication.

This is the third major study of a very low-calorie diet released by Dr. Roy Taylor’s team at the University of Newcastle in the UK. All have shown similar benefit in putting Type 2 diabetes into remission. However, like with the first two, published in 2011 and 2016, we don’t know how long these remissions will last. For most people, the answer may be probably not that long.

As with Dr. Taylor’s previous work, this result has been hyped. The UK Guardian’s third paragraph reported that “Nine out of ten people in the trial who lost 15 kg [33 pounds] or more put their Type 2 diabetes into remission [and]… no longer have to take medication and are free of the symptoms and risks.”

Keep reading to the tenth paragraph, though, and you find the less dramatic claim that “After one year, participants had lost an average of 10 kg [22 lbs], and nearly half had reverted to a non-diabetic state.” So, we’re down from 90% remission to less than 50% remission in one year. What happens the following year?

How they lost weight

While the earlier studies were small groups (11 subjects in the first and 30 in the second) treated in a university clinic, this one followed 298 patients in 49 medical practices in Scotland and Tyneside, England.

All patients in the new study started with a three-month phase of total diet replacement in cans or packages. No food of their own. According to MedPage Today, the packaged food had 825–853 calories a day, consisting of 59% carbohydrates, 13% fat, 26% protein, and 2% fiber.

After three to five months on this diet, a two- to eight-week food reintroduction period followed, which consisted of 50% carbs, 35% total fat, and 15% protein. People were not encouraged to exercise during the total diet replacement, but were during the second phase. They received monthly support, including cognitive-behavioral therapy (CBT) to help them make changes.

Taylor says that “Substantial weight loss results in reduced fat inside the liver and pancreas, allowing these organs to return to normal function.” His team has used MRIs and other scans to document fat loss in those organs. The less fatty liver and pancreas seem to handle insulin better.

“Our findings suggest that even if you have had Type 2 diabetes for six years, putting the disease into remission is feasible,” says Professor Michael Lean from the University of Glasgow, who co-led the study. Lean did stress “the need for long-term maintenance of weight loss through diet and exercise.”

Unfortunately, we know that long-term maintenance of weight loss is rarely achieved by most participants in any intervention, including bariatric surgery. It is not clear how Lean and Taylor propose to keep the weight off their patients.

There is one big positive about this finding, however: “The very large weight losses that bariatric surgery can bring about are not necessary to reverse diabetes,” according to Taylor. “Even though all our volunteers remained obese or overweight, the fat did not drift back to clog up the pancreas.”

Want to try for yourself?

Motivated people have been trying to follow Taylor’s prescription since the first study came out, with some success.

However, there are costs and risks. Health News Review, a site that reviews news about studies, points out that eight weeks of packaged diet foods and the support services would require a significant cost. They also report side effects from the intervention, which included “constipation (56% of participants), headache (45%), increased cold sensitivity (44%), and dizziness (42%). These symptoms tended to [lessen] over time.”

As for what to eat on this diet, in the first study, participants got 600 calories of Optifast diet drink per day, and could eat up to 200 grams (roughly 7 ounces) of nonstarchy green vegetables. You can see other low-calorie diet products here.

Be prepared to make permanent changes when the initial weight loss is over. According to Science Daily, in the second study, the people who maintained their weight loss for six months were typically eating around one-third less than before the study.

Taylor’s diet seems high in carbs for a person with diabetes. For the longer term, a lower-carb, higher-calorie diet might be possible in the maintenance phase.

If someone asks me if they should try Taylor’s approach, I will say, “If you’re careful and maintain contact with your health-care providers, it probably won’t hurt. If you’re highly motivated, it might jump-start your program. But in the long run, I wouldn’t expect much.”

If you decide to try a very-low-calorie approach, please keep in touch with your health professionals, and let us know how it goes.

Want to learn more about Taylor’s previous studies? Read “Starvation Is No Diabetes Cure” and “Can Fasting Help Diabetes?”

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