The project aims to answer the question of whether losing weight on a low calorie liquid diet and keeping it off using a structured, personalised support programme is a viable treatment for putting Type 2 diabetes into remission in the long-term.
Professor Roy Taylor, the lead researcher at Newcastle University, said: “We know that changes in calorie intake can produce changes in body composition that, at least in some people, can put Type 2 diabetes into remission. But this new study is evaluating how well people do using this approach. We are identifying the positive effects and the problems that might be faced.
“We are exploring uncharted territory and along the way there will be challenges, details to unravel, and other questions to ask. But I believe this study will lead to a quantum leap forward in our understanding of how best to manage Type 2 diabetes.”
In the trial, GP practices across Scotland and Tyneside are recruiting people aged 20-65 who are overweight and have been diagnosed with Type 2 diabetes in the last six years. Participants at half the practices are being allocated to receive the current best-available Type 2 diabetes care, while those at the remaining practices receive a low-calorie liquid diet of just 800 calories a day, for between 8 and 20 weeks. Those who complete the diet are then gradually re-introduced to normal food over the next two to eight weeks and receive expert support to help them maintain their weight loss in the long-term.
As well as monitoring the long-term effects of the diet, some of the participants have MRI scans, which show researchers what is happening inside the body during the diet.
This is the largest single research project Diabetes UK has ever funded in its 79-year history. It follows an earlier study that found that 11 people with Type 2 diabetes who spent eight weeks on a low-calorie liquid diet all saw their insulin production return to normal and their Type 2 diabetes put into remission. These findings backed up anecdotal reports and results from bariatric surgery to raise the prospect of transforming the way Type 2 diabetes is treated.
Because the earlier study was designed to better understand the biological processes in the body and only followed its participants for a relatively short period of time, scientists do not yet fully understand the long-term effect of these diets. This is why a longer and larger study is needed to find out whether the benefits of following such a restrictive diet outweigh any adverse effects.
The previous study was carried out in a research setting and so it is unclear whether such diets can be transferred to a larger scale as part of routine GP care, where large numbers of overweight people with Type 2 diabetes are managed in the UK.
Because of these unanswered questions, Diabetes UK does not yet generally recommend low-calorie liquid diets to people with Type 2 diabetes. But the charity is confident that the new study will answer these questions and so give the NHS enough evidence to make a decision on whether low-calorie diets should be offered as a routine treatment option.
Individuals who are highly motivated to reverse their Type 2 diabetes to normal would reasonably make an individual decision on the basis of the information provided on our Reversing Type 2 Diabetes page.
The content on this page is adapted from a Diabetes UK press release (December 2015).