Researchers in the UK placed 30 overweight adults with type 2 diabetes on a very low calorie, mostly liquid diet for 8 weeks. (Nestle’s OPTIFAST was provided.) Participants underwent a follow-up, 6-month intensive weight management program. At the end of the 8-week plus 6-month program, 13 of 30 (43%) participants essentially reversed their diabetes by maintaining a fasting glucose below 126 mg/dL while taking no glucose-lowering medications:
Very-Low-Calorie Diet And 6 Months Of Weight Stability In Type 2 Diabetes: Pathophysiologic Changes In Responders And Nonresponders, Diabetes Care, 21 March 2016
OBJECTIVE Type 2 diabetes mellitus (T2DM) is generally regarded as an irreversible chronic condition. Because a very-low-calorie diet (VLCD) can bring about acute return to normal glucose control in some people with T2DM, this study tested the potential durability of this normalization. The underlying mechanisms were defined.
RESEARCH DESIGN AND METHODS People with a T2DM duration of 0.5–23 years (n = 30) followed a VLCD for 8 weeks. All oral agents or insulins were stopped at baseline. Following a stepped return to isocaloric diet, a structured, individualized program of weight maintenance was provided. Glucose control, insulin sensitivity, insulin secretion, and hepatic and pancreas fat content were quantified at baseline, after return to isocaloric diet, and after 6 months to permit the primary comparison of change between post–weight loss and 6 months in responders. Responders were defined as achieving fasting blood glucose
RESULTS Weight fell (98.0 ± 2.6 to 83.8 ± 2.4 kg) and remained stable over 6 months (84.7 ± 2.5 kg). Twelve of 30 participants achieved fasting plasma glucose
CONCLUSIONS A robust and sustainable weight loss program achieved continuing remission of diabetes for at least 6 months in the 40% who responded to a VLCD by achieving fasting plasma glucose of
The average weight loss after 8 weeks was 14.2 kg or about 31 pounds. Most succeeded in maintaining their lower weight for 6 months.
There were improvements in blood pressure, triglycerides, and cholesterol over the 6-month maintenance period. Plasma insulin levels also fell in the group.
It has previously been shown that a low-calorie, weight-loss diet can reverse type 2 diabetes. Keeping the weight off is key, however, and one criticism of this study is the short 6-month weight maintenance phase.
A more detailed description of the diet, from Medscape:*
The 8-week very low-calorie diet consisted of a three-times daily liquid formula containing 43% carbohydrates, 34% protein, and 19.5% fat, providing about 624 kcal/day. Subjects were also allowed to eat nonstarchy vegetables and were encouraged to drink at least 2 L/day of calorie-free beverages and to maintain normal activities. One-to-one support was provided via telephone, email, text messages, or face-to-face contact.
After the 8 weeks, solid food was gradually introduced in weight-maintaining quantities (approximately 1600 to 2000 kcal per day, although the focus was on weight of food portions).
* Very Low-Calorie Diet May Trigger Type 2 Diabetes Remission, Medscape, 31 March 2016