Type 2 Diabetes and Weight Loss

The prevalence of Type 2 diabetes has increased due to the obesity epidemic. It is estimated that there are 400 million people worldwide with Type 2 diabetes. I truly believe that figure is an underestimate as emerging societies incorporate the western diet.

There is HOPE!!  Recent studies show that Type 2 diabetes can be placed into remission not with pharmaceutical intervention but with weight loss and lifestyle modifications.   The DIRECT trial in 2017 compared 2 groups of approximately 300 patients. One half was treated with conventual best practices and other group was placed on a low calorie carbohydrate diet for 3-5 months.  After 1 year the low-calorie group had weight loss of>15kg and 46% experienced remission of diabetes compared to only 4%in the control group.

Another study looked at 350 patients, 87 patients received the usual care and the other 260 patients were placed on low carbohydrate diet and could continue medications.  The results showed that 60% of the 2nd group achieved A! C levels<6.5. There was 12% weight loss, 24% reduction in triglyceride levels, 18% increase in HDL and 38% reduction in c reactive protein. These results are astonishing!

There is controversy regarding reversal vs remission. More studies need to be done to elucidate what diets may be better and whether the complications are reduced or eliminated. My belief is that the modifications induce remission. The underlying mechanism for the abnormal glucose regulation does not disappear. If the weight returns the diabetes will return. The message here is simple: weight loss and lifestyle modification put you in control of your disease. Medications can be reduced or even eliminated. You can also decrease the complications associated with the medications and complications from elevated and uncontrolled glucose

Dietary and lifestyle medications equal better quality of life.