There are two types of diabetes mellitus that were previously known as juvenile onset and adult onset diabetes, but are now know as type 1 and type 2 diabetes, respectively. Type 1 diabetes is an autoimmune disease that results from autoantibody destruction of pancreatic beta cells, which produce insulin. Type 1 diabetes usually develops during the childhood years and is treated with insulin. Type 2 diabetes results from insulin resistance and decreased insulin secretion from the pancreatic beta cells. Diet, exercise, and weight loss have long been known to help ameliorate the effects of type 2 diabetes. In fact, weight loss has been shown to decrease the severity of type 2 diabetes, and even decrease the medication requirement of patients. We have previously discussed the improvement of the severity of diabetes found in patients that undergo bariatric surgery. In these patients, it is thought that the gastric bypass surgery causes changes in intestinal hormone metabolism which then results in improvement of glucose control and insulin resistance. Many patients that undergo gastric bypass surgery can eventually stop taking their diabetic medications as a result of the improvement in their diabetes. Researchers from Newcastle University in England, lead by Dr. Roy Taylor, have presented data this weekend at the American Diabetes Association conference showing that type 2 diabetes can be cured with a low calorie diet. Their results were also published online in the journal Diabetologia. The results are very remarkable because type 2 diabetes was thought to be a chronic and inevitably progressive disease that was manageable but not curable. In their study, the researchers followed 11 newly diagnosed diabetic patients while they adhered to a 600 calorie diet. The study participants were evaluated before the low calorie diet and at the 1, 4, and 8 week time points. They were tested for basal hepatic glucose output, hepatic and peripheral insulin sensitivity and beta cell function. In addition, pancreatic and liver fat content was measured using magnetic resonance imaging. After one week of the calorie restricted diet, fasting plasma glucose was normalized. Liver fat content decreased in the diabetic group and the pancreas’s secretion of insulin increased in response to dietary sugar while on the low calorie diet. At the three month timepoint, seven of the eleven study participants were free of diabetes. The authors wrote, “Normalisation of both beta cell function and hepatic insulin sensitivity in type 2 diabetes was achieved by dietary energy restriction alone. This was associated with decreased pancreatic and liver triacylglycerol stores. The abnormalities underlying type 2 diabetes are reversible by reducing dietary energy intake”. These are remarkable results and if they can be implemented on a large scale would dramatically change the health of millions of people and save countless dollars in diabetes related health complications. Future studies should focus on whether this low calorie diet is a viable treatment option for diabetic patients.
E. L. Lim et al. “Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol” Diabetologia published online June 9, 2011.