Newcastle Magnetic Resonance Centre

Reversing Type 2 Diabetes

Reversing Type 2 Diabetes and ongoing remission

Public Information

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 Diabetes Reversal Information (PDF: 333KB).

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 Alison Barnes, senior diabetes dietitian, Newcastle University and Tom Crame, dietitian intern, Newcastle University.

More information on low calorie diets is available from the Diabetes UK website and the British Heart Foundation provide advice on weight loss.

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, here are some notes for you to take to your doctor.

Download our information sheet for doctors on the Information for Doctors (PDF: 227KB).

Further information

We have now conducted a large study on reversing type 2 diabetes in Primary Care.  Read all about it here: Diabetes Remission Clinical Trial (DiRECT).

Christine Wilcox-Baker has created an art project called 'Seven thousand feet' which takes its name from the approximate number of diabetes related lower limb amputations in the UK each year.  Please refer to Christine's website and additional information on the exhibition can be found here.


Our work has shown that type 2 diabetes is not inevitably progressive and life-long. By identifying the cause of the condition it has been possible to design appropriate management. 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. For practical information on HOW TO REVERSE YOUR DIABETES, click on the 'Public Information' tab.

It has been possible to work out the basic mechanisms which lead to type 2 diabetes. The Twin Cycle Hypothesis of 2008 has been tested and found to be correct. Too much fat within liver prevents normal insulin action and too much fat within the pancreas 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 personally 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, type 2 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 aimed to 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 is known as DiRECT (DIabetes REmission Clinical Trial). Participating general practices in Tyneside and Scotland will be randomised either a) to use the low calorie diet followed by an intensive weight maintenance phase, or b) 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 (8 hours structured training followed by ongoing support).

The expertise of academic staff at Glasgow and Newcastle will be combined. 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 details at:

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:

Scientific Information

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:

Further information

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 the scientific review, Pathogenesis of type 2 diabetes (PDF: 471KB) 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 (PDF: 195KB) 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 (PDF: 363KB).

A review describing the beta cell de-differentiation (PDF: 1081KB) explains why the condition is reversible. Under the endoplasmic reticulum stress caused by excess intracytoplasmic fat, the cell goes into a survival mode and switches off specialised gene expression. Removal of the fat permits re-differentiation.

See the review summarising the new understanding of type 2 diabetes and discussing long term dietary management of the post-diabetic state: Diabetologia Review 2017

The first year results of DiRECT were presented at the International Diabetes Federation (IDF), (5/12/17) meeting in Abu Dhabi and have been published in The Lancet. DiRECT Year 1 results and supplementary appendix

The study shows that around half of people with type 2 diabetes of duration less than 6 years can reverse their condition and remain in 'remission' after 1 year.

The pathophysiological basis of reversal of type 2 diabetes is described in a major paper: Taylor R et al. Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for beta cell recovery. Cell Metabolism 2018. Aug 2. pii: S1550-4131(18)30446-7. doi: 10.1016/j.cmet.2018.07.003. Taylor et al Cell Metabolism 2018


Diabetes Remissions Clinical Trial – understanding why significant weight loss results in remission of Type 2 diabetes is at the heart of DiRECT.

DiRECT is a collaboration between Professor Roy Taylor, Newcastle University and Professor Mike Lean, University of Glasgow.

  • One third of all people taking part were free of diabetes at 2 years.
  • Around three quarters of everyone who were in remission at 1 year stayed in remission at 2 years.
  • The group who embarked on rapid weight loss had fewer serious medical problems in the second year of DiRECT.

DiRECT results: Direct results at 2 years (PDF: 627KB) full paper and the online DiRECT Appendix (PDF: 499KB) are now available. These files are of the final manuscripts as copyright prevents posting of the Lancet paper itself.

Watch Professor Taylor’s interview: Has DiRECT and Type 2 diabetes remission gone mainstream? (Medscape, 8 March 2019) 


Media coverage and press releases:

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