WEIGHT loss of as little as 11Ibs is enough to reverse diabetes in some patients according to a landmark study which found that a low calorie diet was more effective than drugs against the condition.
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While obese patients have been known to reverse Type 2 diabetes as a result of massive weight loss following gastric band surgeries, the latest findings show that shedding an average of just 22Ibs is enough to reverse the condition in around half of patients - without any medication. In a third of patients, losing between 11Ibs and 22Ibs was also enough to put their diabetes into remission.
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The DiRECT (Diabetes Remission Clinical Trial) study, published in the Lancet and presented at a diabetes conference in Abu Dhabi, was co-led by Glasgow University's chair of human nutrition, Professor Mike Lean.
It recruited 298 adults from GP practices across Scotland and the Tyneside region of England who had been diagnosed with Type 2 diabetes within the previous six years.
Half continued on diabetes drugs with no weight loss intervention, while the other 149 participants were taken off all diabetes and blood pressure medication and placed on a nutritionally-balanced liquid diet of between 825 and 853 calories a day instead for three to five months, followed by gradual food reintroduction and long-term support to maintain weight loss.
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Nearly half - 68 participants - had reversed their diabetes within one year of starting the trial, compared to six in the control group.
More than half of those who lost 22 to 33Ibs achieved remission, along with 34 per cent who lost between 11 and 22Ibs.
Among those who lost 33Ibs or more, 86 per cent reversed their diabetes.
Almost half the participants were also able to remain off all anti-hypertensive drugs with no rise in blood pressure.
Prof Lean said: “Our findings suggest that even if you have had Type 2 diabetes for six years, putting the disease into remission is feasible.”
He added that GPs should encourage patients to lose weight as soon as possible after the condition is diagnosed. He said: “Putting Type 2 diabetes into remission as early as possible after diagnosis could have extraordinary benefits, both for the individual and the NHS.
"DiRECT is telling us it could be possible for as many as half of patients to achieve this in routine primary care, and without drugs.”
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Worldwide, the number of people with Type 2 diabetes has quadrupled over 35 years, largely due to the growth in obesity.
The condition costs the NHS around £14 billion a year, and can lead to a number of serious complications such as cardiovascular disease, kidney disease or stroke. In Scotland alone, diabetes drugs are costing the NHS £90 million a year - up from £73.2m in 2012/13.
Prof Lean added that while the weight management programme was quite expensive it "pays for itself in time" as other medical costs are avoided. He said: "It is actually cheaper than some of the drugs prescribed for Type 2 diabetes."
Co-author Professor Roy Taylor, from Newcastle University, said the findings should "revolutionise" the way the disease is treated.
He said: “Rather than addressing the root cause, management guidelines for Type 2 diabetes focus on reducing blood sugar levels through drug treatments. Diet and lifestyle are touched upon but diabetes remission by cutting calories is rarely discussed."
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Prof Taylor said that while bariatric surgery such as gastric bands would reverse diabetes in around three-quarters of patients, it was "more expensive and risky, and is only available to a small number of patients”.
He added: “Our findings suggest that the very large weight losses targeted by bariatric surgery are not essential to reverse the underlying processes which cause Type 2 diabetes.
"The weight loss goals provided by this programme are achievable for many people. The big challenge is long-term avoidance of weight re-gain."
A follow-up study over the next four years will determine whether weight loss and remission are achievable long-term.
The team previously confirmed that Type 2 diabetes is caused by excess fat within the liver and pancreas, and that consuming a very low calorie diet could restore normal glucose.
However, this new study is the first to demonstrate that a weight management programme can achieve remission of Type 2 diabetes in routine primary care.
In a comment piece, accompanying the study, Professor Emeritus Matti Uusitupa from the University of Eastern Finland, said the findings "indicate that weight loss should be the primary goal in the treatment of type 2 diabetes" and that "the time of diabetes diagnosis is the best point to start weight reduction and lifestyle changes"
Dr Elizabeth Robertson, director of research at Diabetes UK, which has committed more than £32.8m to the DiRECT study, welcomed the findings.
She added: “It’s very important that anyone living with Type 2 diabetes considering losing weight in this way seeks support and advice from a healthcare professional.”
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