By Sarah Knapton, Science Editor
15 March 2017
Type 2 diabetes can be reversed in just four months by cutting calories, exercising and keeping glucose under control, a trial has shown.
Although the condition is considered to be chronic, requiring a lifetime of medication, Canadian researchers proved it was possible to restore insulin production for 40 per cent of patients.
The treatment plan involved creating a personalized exercise regime for each trial participant and reducing their calories by between 500 and 750 a day. The participants also met regularly with a nurse and dietician to track progress and continued to take medication and insulin to manage their blood sugar levels.
After just four months, 40 per cent of patients were able to stop taking their medication because their bodies had begun to produce adequate amounts of insulin again.
The researchers at McMaster University in Ontario, Canada, said the programme worked because it gave the insulin-producing pancreas ‘a rest.’
"The research might shift the paradigm of treating diabetes from simply controlling glucose to an approach where we induce remission and then monitor patients for any signs of relapse," said the study's first author, Dr Natalia McInnes, of McMaster.
"The idea of reversing the disease is very appealing to individuals with diabetes. It motivates them to make significant lifestyle changes.
“This likely gives the pancreas a rest and decreases fat stores in the body, which in turn improves insulin production and effectiveness."
The number of people in the UK with type 2 diabetes has trebled over the last two decades, rising from 700,000 in the 1990s to 2.8 million today, according to new figures from Cardiff University. The condition costs the NHS around £14 billion a year, but if the intervention worked at the same level for Britons, then more than one million people could benefit.
The condition occurs when an individual does not produce enough insulin, the hormone that allows cells to absorb glucose into the blood, or when the insulin that is produced does not work properly.
As a result, blood sugars build up in the body and the cells do not receive the energy they need. Over time type 2 diabetes can lead to damage to the blood vessels, nerves and organs and trigger kidney disease and blindness. It also increases the risk of a heart attack and stroke.
The increased number of people with the disease has been linked to rising levels of obesity. Between 1993 and 2010 the proportion of obese people in the UK went from 13 per cent to 26 per cent for men and from 16 per cent to 26 per cent for women.
The charity Diabetes UK is currently funding a large trial to find out if a low-calorie diet can put type 2 diabetes into remission in the long term.
Emily Burns, the research communications manager of Diabetes UK said: “We’re looking forward to seeing the results in 2018. In the meantime, we encourage people with Type 2 diabetes to follow a healthy diet that is low in sugar, saturated fats and salt.
“We know that diet, exercise and medications can help people with Type 2 diabetes to manage their condition. We’re starting to see mounting evidence that putting Type 2 diabetes into remission is feasible as well.”
Naveed Sattar, a professor of metabolic medicine at the University of Glasgow, said: "We know now that intensive diet changes – with calorie restriction over period of few weeks to few months can reverse diabetes in many patients but what we need to determine are ways to keep the weight off and keep people in diabetes 'remission'.
"What happens with weight loss per se is that fat is sucked out of key organs relevant to the efficient metabolism of sugar so this means liver, muscles and pancreas lose fat and start to restore their normal functions leading to lower sugar levels.
"The present trial is unusual in that it also uses drugs to help get to low glucose levels in the short term with the hypothesis that getting sugars to normal may also help reduce toxic effects on pancreas and kick starts its function.
"However, this is a very controversial hypothesis. Most researchers think that in order to have diabetes undergo proper 'remission' it’s about more substantial weight loss, without use of drugs and to sustain benefits required keeping most of the weight lost off. I tend to agree with latter notion."
The research was published in the Journal of Clinical Endocrinology & Metabolism.
Elsewhere researchers from Copenhagen University Hospital in Denmark warned that ibuprofen should not be sold over the counter after finding that it raised the risk of a heart attack by 31 per cent.