Our work has shown that type 2 diabetes is not inevitably progressive and life-long. We have demonstrated that in many people who have had type 2 diabetes for up to 10 years, major weight loss returns insulin secretion to normal.
It has been possible to work out the basic mechanisms which lead to type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss.
A crucial point is that individuals have different levels of tolerance of fat within liver and pancreas. Only when a person has more fat than they can cope with does type 2 diabetes develop. In other words, once a person crosses their personal fat threshold, type 2 diabetes develops. Once they successfully lose weight and go below their personal fat threshold, diabetes will disappear.
Some people can tolerate a BMI of 40 or more without getting diabetes. Others cannot tolerate a BMI of 22 without diabetes appearing, as their bodies are set to function normally at a BMI of, say 19. This is especially so in people of South Asian ethnicity.
Award of major grant
In October 2013, Diabetes UK announced the award of its largest research grant ever. It builds upon the breakthrough in understanding the pathophysiology of diabetes and the related demonstration that short term Type 2 diabetes could be reversed to normal. This is brought together with work conducted in Glasgow on use of low calorie liquid diets in primary care.
The study will answer two main questions:
- Can type 2 diabetes be routinely reversed in Primary Care?
- Is the long term effect of this intervention better than conventional treatment?
The study will be known as DiRECT (DIabetes REmission Clinical Trial). Participating general practices in Newcastle and Glasgow will be randomised either to use the low calorie diet followed by an intensive weight maintenance phase, or to best possible care according to current guidelines. In order to deliver the low calorie diet, together with the critically important backup and support, primary care staff will be trained by the study team.
The expertise of academic staff at Glasgow and Newcastle will be combined with previous experienced specialist dieticians from Counterweight Ltd. Counterweight was formed as a company in order to keep together the expertise developed during the Counterweight Project which has been highly successful in achieving and maintaining weight loss in the primary care setting.
Study volunteers in the Newcastle area will also undergo detailed magnetic resonance investigations coupled with metabolic tests to examine further the basic mechanisms which bring about the return to normal blood glucose control. Additionally, detailed psychological assessments will be carried out to understand the response of individuals to this management approach and identify factors which effect adherence.
View the DiRECT study protocol (PDF: 879KB).
This study is a collaboration between Professor Mike Lean, Professor of Human Nutrition at Glasgow University and Professor Roy Taylor, Professor of Medicine and Metabolism at Newcastle University, as the Chief Investigators.
The Principal Investigators are:
The information on this page is for people with diabetes. It includes media coverage and academic papers on the low calorie diet, as well as case studies and sample meal plans.
Download the reversing Type 2 diabetes information leaflet (PDF: 260KB).
Watch Professor Taylor's Newcastle University Public Lecture on reversing type 2 diabetes (4th November 2014).
Read Richard Doughty's personal story Type 2 diabetes and the diet that cured me on the Guardian website, including a video interview of another personal story. You can also read an update from Richard, I reversed my diabetes in just 11 days, on the Mail Online.
Get sample recipes and meal plans (PDF: 385KB) devised by Karen Heron, a dietician at Newcastle Diabetes Centre.
Information for your doctor
It is important that you discuss the management of your diabetes with your own doctor. It will take years for this new knowledge to become incorporated into textbooks and guidelines, so your doctor may be wary of information from the internet. Therefore, our researchers have written some notes for you to take to your doctor.
Download our information sheet for doctors on the practical management of type 2 diabetes (PDF: 220KB).
Academic papers and data:
- very low calorie diet and 6 months of weight stability in Type 2 diabetes (PDF: 597KB)
- diet versus surgery (PDF: 791KB)
- use of a very low calorie diet in long- and short-duration Type 2 diabetes (PDF: 168KB)
- normal weight individuals who develop Type 2 diabetes: the personal fat threshold
Media coverage and press releases:
- the press release for the original trial
- The Food Hospital (Channel 4)
- Hairy Dieters: How to love food and lose weight (BBC2 August 2012, repeated January 2013)
Further information on the Hairy Dieters programme including experts' hints and tips and regular updates on the Hairy Dieters' progress can be seen on the BBC website. The programme promoted the University's aim to help us all live healthy, longer lives and to encourage us all on that path.
The information on this page is for doctors and scientists. It includes slides on various aspects of the reversal of Type 2 diabetes as well as published papers.
Download our slides on:
- Counterpoint (PDF: 85KB)
- Counterbalance (PDF: 701KB)
- pancreas fat (PDF: 207KB)
- the DiRECT study (PDF: 95KB)
- personal fat thresholds (PDF: 481KB)
In 2008, we published the Twin Cycle Hypothesis to explain the cause of Type 2 diabetes. This hypothesis predicted that diet could entirely reverse Type 2 diabetes. Read our scientific review, Pathogenesis of Type 2 diabetes on the US National Library of Medicine website.
A clinical study designed to test the hypothesis was funded by Diabetes UK. The results were very clear. Weight loss averaging 15kg (2 stone 5lb) achieved over 8 weeks caused two distinct sets of changes. Within seven days, liver fat had fallen by 30%, liver insulin sensitivity had returned to normal and fasting blood glucose had become normal. By eight weeks, pancreas fat content had returned to normal and insulin secretion by the pancreas had returned to normal. Read the full scientific paper, Reversal of Type 2 diabetes and the related Newcastle University Press Release, Diet Reverses Type 2 Diabetes.
This new understanding of what causes Type 2 diabetes and how it can be completely reversed has been used by individuals worldwide, a report has been published documenting practical management of Type 2 diabetes in respect of reversal (PDF: 85KB).
Professor Taylor was awarded the 2012 Banting Lectureship of Diabetes UK. Read his lecture Reversing the twin cycles of Type 2 diabetes (PDF: 543KB).
Scientists and doctors with access to the journal Diabetes Care, can read a full review of the science underlying this matter: Type 2 diabetes: etiology and reversibility.