New research could revolutionise treatment of a disease that costs Ireland €70m a year, says Dr Michael Mosley
The results of a big new study which could revolutionise the way that not only type 2 diabetes but obesity are treated were released last week. The study, called DiRECT (Diabetes Remission Clinical Trial), which involved treating people with type 2 diabetes through a rapid weight loss diet, was published in a leading medical journal, The Lancet.
The study, which began in 2013, involved 298 patients who had suffered from type 2 diabetes for less than six years. They were drawn from 49 GP practices in Scotland and the North of England.
When the patients agreed to take part in the study they were randomly allocated to either getting standard diabetes care from their GP, or going on a rapid weight loss diet.
On this diet they were asked to stick to 800 calories a day for up to 20 weeks, then switch to a programme of long-term support to maintain weight loss.
I have been eagerly awaiting the results of this study ever since the publication of my book, The 8 Week Blood Sugar Diet, two years ago. This book, which includes recipes and a detailed programme for reversing pre-diabetes and type 2 diabetes, was based on exactly this rapid weight loss approach.
Since the book was published I have received thousands of letters and emails from people who have lost lots of weight and are back to full health, but I was obviously keen to see how well the claims I made in my book would stand up to a rigorous scientific trial carried out in some of the most economically deprived parts of the UK.
So I was delighted when I met up with diabetes expert Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, one of the lead authors of the new study, and he showed me the results. They were truly remarkable.
One in four people who had been allocated to the rapid weight loss side of the trial had lost more than 15kg, which was impressive, and kept it off for more than a year, which was even more impressive.
A key finding of the study was the more weight people lost, the more likely they were to get their blood sugars under control without medication. 86pc of those who lost 15kg or more put their diabetes into remission. This fell to about 7pc in those who lost less than 5kg.
All in all, nearly half the patients (46pc) who were allocated to the rapid weight loss regime managed to get their blood sugars back to normal, without medication, compared to only 4pc of those getting standard diabetes care.
People like Isobel Murray from North Ayrshire, who lost more than 22kg in 17 weeks and is no longer on any diabetes drugs.
“I was on increasing doses of medication and becoming more and more ill every day,” she said.
“Now I feel amazing and though I still get my diabetic checks done I no longer think of myself as a diabetic.”
Professor Taylor, who had inspired me to write The 8 Week Blood Sugar Diet, was obviously very pleased and excited by these findings. They confirmed his previous research, but which had been carried out with smaller numbers and in a controlled clinical setting. This was a trial done in general practice, run mainly by practice nurses.
Professor Taylor said: “These findings really could revolutionise the way Type 2 diabetes is treated. This builds on our previous work, so it is very satisfying.”
There is an urgent need to do something to hold back the epidemic of diabetes, other than simply keep dishing out more and more pills. According to Diabetes Ireland, there are roughly 226,000 people in Ireland with diabetes, and more are being added every year as the population gets older and fatter. The number of diabetics in Ireland has quadruped over the last 30 years.
Some have type 1 diabetes, an autoimmune condition which typically develops when you are young and does not respond to weight loss treatments.
The vast majority, however, have type 2 diabetes, which is typically caused by carrying a bit too much fat around the waist.
You don’t have to be overweight to have type 2 diabetes, but it certainly contributes to your risk.
On top of those who have confirmed diabetes, there are 60,000 or so who have it and don’t know they have it, plus another 400,000 people who have pre-diabetes, where blood sugar levels are raised but not yet in the diabetic range.
Very few people with pre-diabetes are aware they have it, let alone that they will probably develop the full blown disease.
Complications of diabetes include an increased risk of going blind, having a heart attack, going into kidney failure, becoming demented and losing a limb.
It’s also a very expensive disease to treat. According to a recent study, treating diabetes costs the Irish health service more than €70m a year, and if you were to include loss of earnings and people having to retire early it would be many times more than that.
I’m particularly interested in diabetes because five years ago I discovered, after a routine blood test, that I was a type 2 diabetic.
This was a particularly nasty shock to me as my father had died at the relatively early age of 74 from complications of diabetes.
Rather than start on medication, which is what my doctor advised, I decided to find something I could do to overcome diabetes without drugs. In the course of my research I discovered “intermittent fasting”, where instead of dieting every day you cut your calories a few days a week.
After talking to experts I ended up creating what I called the 5:2 diet, where I cut my food intake to around 600 calories a day, two days a week, and ate as healthily as possible on the other five days.
Using this approach, I rapidly lost 10kg and returned my blood sugars to normal, where thanks to my maintaining this weight loss, they have stayed ever since.
I later wrote a book, The Fast Diet, all about the benefits of intermittent fasting. It became an international best seller.
But why did losing weight make such a big difference to my blood sugar levels?
Soon after writing The Fast Diet, I met Professor Taylor. He said that the main reason so many people develop blood sugar problems later in life is because we put on too much visceral fat – fat around the gut.
This not only makes us look chubbier but clogs up our liver and pancreas. “Get rid of that fat”, he told me, “and most people can get their blood sugar levels back to normal without medication”.
This was a remarkable claim because the accepted wisdom is that type 2 diabetes is incurable and invariably progressive.
Most of the doctors I spoke to were sceptical that patients would start a rapid weight loss diet, let alone stick to it.
One man I spoke to said he’d been told by his GP that it would never work and he should not be worried “when you fail”.
Well, it turns out they were wrong and Professor Taylor was right. I can only hope, following this new study, that more doctors will start recommending this approach to patients.
As Professor Taylor said to me, the last time we met:
“What doctors in general haven’t recognised is how much people with type 2 diabetes hate having it. In my experience people will jump for it given the chance.”
Originally published by Dr Michael Mosley at Independent.ie
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Diabetes-Cure.me and the submitting author have used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. Please read our full Disclaimer.
Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for “FAIR USE” for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. Fair use is a use permitted by copyright statute that might otherwise be infringing. Non-profit, educational or personal use tips the balance in favour of fair use. Please read our full Disclaimer.