Reversing Type 2 Diabetes
Newcastle University's findings could benefit millions of people across the globe
The World Health Organization estimates that, in just over a decade, diabetes will be the seventh leading cause of death worldwide. As well as causing serious long-term health problems including loss of vision, blindness, amputation of the lower limbs and feet, diabetes is a major cause of kidney failure, heart attack and stroke.
Type 2 diabetes is a chronic disease which occurs when the pancreas does not produce sufficient insulin, due to a build-up of fat. However, research by Newcastle University's Professor Roy Taylor has found that losing weight can help patients reverse their Type 2 diabetes to the point where they no longer require medication. "If you ask me how much weight you need to lose to make your diabetes go away, the answer is one gram!" says Professor Taylor. "But that gram needs to be fat from inside the pancreas."
The research has also confirmed Professor Taylor’s own Twin Cycle Hypothesis – that Type 2 diabetes is caused by excess fat within the liver as well as the pancreas. This fat causes the liver to respond poorly to insulin. As insulin controls the normal process of making glucose, the liver then produces too much glucose. Simultaneously, excess fat in the liver increases the normal process of export of fat to all tissues – including the pancreas.
An ongoing trial aims to find an effective and accessible way to put Type 2 diabetes into remission for the long-term. Results from the first year of the trial, published in late 2017, have identified that people in the first six years of type 2 diabetes who follow a low-calorie programme, with support from their GP, can reverse their diabetes for at least a year. The study is ongoing.
The trial, DiRECT (Diabetes Remission Clinical Trial), found that almost nine out of 10 people taking part in the trial lost 15kg or more or put their Type 2 diabetes into remission. The study also found that almost half of those who were put on a low-calorie diet for three to five months were able to stop their Type 2 diabetes medication.
"Substantial weight loss results in reduced fat inside the liver and pancreas, allowing these organs to return to functioning normally," says Professor Taylor. "What we're seeing from DiRECT is that losing weight isn’t just linked to better management of Type 2 diabetes: significant weight loss could actually result in lasting remission."
Professor Roy Taylor
Professor Roy Taylor is Director of Newcastle Magnetic Resonance Centre and an Honorary Consultant Physician at Newcastle upon Tyne Hospitals NHS Foundation Trust. His work has shown that Type 2 diabetes is not inevitably progressive and life-long.
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