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Medically supervised hypocaloric diet succeeds in reversing type 2 diabetes, but is it the answer for all patients, asks Áilín Quinlan
AFTER more than 20 years struggling to manage type 2 diabetes With a heavy drug program comprising three different types of insulin, Phyllis Bacon was faced with a sinister choice:
"I could die or find myself in a wheelchair," recalls the 58-year-old stuffer who was diagnosed at the age of 32, she was diagnosed with type 2 diabetes and by the end of her 50s she was taking three different types of insulin, as well as blood pressure medications, cholesterol and pain
. lived his life. Last May, Phyllis embarked on a diet of 600 calories a day under medical supervision and was removed from insulin
It is still early, says resident of Kilbarrack, Dublin, but she already feels much better. Type 2 diabetes, formerly known as adult or non-insulin-dependent diabetes, is a chronic condition that affects how the body metabolizes sugar (glucose), a major source of fuel. With type 2 diabetes, the body resists the effects of insulin, a hormone that regulates the movement of sugar in cells or does not produce enough insulin to maintain a normal glucose level. Diabetes affects many major organs, including the heart, blood vessels, nerves, eyes, and kidneys.
More and more research claims that low-calorie diets can have an impact on type 2 diabetes in Britain and Canada, have shown that people embarking on an accident plan can potentially reverse their diabetes. There is growing evidence that people with type 2 diabetes who are successful in losing weight can reverse their condition. For example, a low calorie diet of about 800 calories a day – about half of the recommended caloric intake of 1,600 to 2,000 calories for an inactive woman – helps to remove fat from the pancreas and restore it. normal production of insulin
. The results of a 2016 study by Roy Taylor, professor of medicine and metabolism at Newcastle University, made international headlines after 30 volunteers with type 2 diabetes embarked on the same diet of 600 to 700 calories a day. Participants lost an average of 14 kilograms – just over two stones. During the next six months, they found no weight.
Overall, 12 diabetic patients for less than 10 years have reversed their condition. Six months later, these patients remained without diabetes. Although the volunteers lost weight, they remained overweight or obese – but they had lost enough weight to allow normal insulin production.
"The study also answered the following question:" If I lose weight will I stay free from diabetes? "The simple answer is yes," Taylor said at the time.
"What we have shown is that it is possible to reverse your diabetes even if you have had the condition for a long time, up to about 10. If you have had a longer diagnosis, then Do not give up hope – a major improvement in blood glucose control is possible. "
A previous study conducted by Professor Taylor, published in 2011, also showed that diabetes could be
Last year, a Canadian study showed that type 2 diabetes can be reversed in just four months by reducing calories, exercising and controlling glucose, one trial has shown.
McMaster University in Ontario, Canada, proved that it was possible to restore insulin production in 40% of patients
This study involved a diet regimen. personalized exercise for each participant in the trial and reducing their caloric intake from 500 to 750 per day. 19659003] After only four months, 40% of patients could stop taking their medication because their body had started producing adequate amounts of insulin again.
Francis Finucane, a consultant endocrinologist at Galway Universi ty Hospitals and NUI Galway, says that he uses the low-calorie approach for some patients for whom it is appropriate.
"After careful clinical evaluation by the general practitioner or the endocrinologist, some patients with diabetes may well face a very high calorie restriction.
" There is some evidence that these interventions work well in the short term. They have a role to play for some patients, the question is which patient? "
Further clinical research is needed, he says, because not all patients are doing well on these diets.
" My clinical experience in Galway that about 50% of diabetic patients type 2 who have been selected for such programs do not complete or can not complete the program.
"Only some patients with type 2 diabetes can tolerate the low-calorie diet and those who tolerate The problem is that they are only fine for the duration of the diet and that once they stop, the weight accumulates and they come back. "
The incidence of type 2 diabetes – which usually develops slowly in adulthood, and is a Progressive disease that can sometimes be treated with diet and exercise, but more often requires diabetes medications and / or insulin injections – is steadily increasing in this country.
Although the lack of a registry cann To be sure of the exact figures, the total number of people living with diabetes in this country is estimated at nearly 226,000 of which about 16,000 are suffering from Type 1 diabetes.
According to Diabetes Ireland, more than 854,000 adults over 40 are now at risk of developing, or have already, type 2 diabetes. More alarming, depending on the organization, there are still has 304,382 people aged 30 to 39 who are overweight and do not take the recommended physical activity, which puts them at increased risk for chronic disease. The International Diabetes Federation estimates that by 2030 there will be 278,850 people with type 2 diabetes.
The news is worsening – given the increase in the rate of Obesity in younger age groups, says Diabetes Ireland, The Prof. Endocrinologist Donal O 'Shea, who is attached to the UCD, points out that the costs badociated with diabetes now account for between 10% and 12% of total health. budget.
"It's a huge sum – for a single illness, spending so much is extraordinary," he adds, adding that despite the hype around their potential to reverse diabetes, low-calorie diets might not not be the solution for everyone
Research shows that restricted calorie diets or soon after diagnosis can reverse it and put diabetes into remission.
"I think that's not the answer. It's fair to say that the medical community is still trying to understand how a very low … caloric diet can reverse type 2 diabetes. We always try to understand where that fits into the routine management of the disease. "
This is a new and exciting field, he says, that pushes the theory on managing type 2 diabetes a little further, suggesting the diet could be able to reverse it in cer certain situations.
"However, the diabetes community has not yet understood how this is happening or to whom it might be particularly suited.
" To improve our health and reduce incidence of type 2 diabetes, we must be physically active, eat a balanced diet and avoid highly processed foods high in fat and sugar – or consume less, "he advises
. Fasting (diets that include periods of fasting and non-fasting for a defined period of time) is the answer either, he says.
"It's fine if you're a mouse and live longer, but we have no evidence however, it recognizes, if the goal is to reduce overall caloric intake in an overweight or obese person who can join, and finds that it works, well and good.
"Some people say they are doing very well by reducing their calorie intake a few days a week – some people find that it works for them. "
In September, Dr. Eva Orsmond, who worked in the field of diabetes and weight loss For 17 years, she will publish her latest book, Reverse Type 2 Diabetes.
" Diabetes type 2 lives in visceral fat, "she explains." This produces inflammatory hormones. When people lose their visceral fat, their resistance to insulin disappears. The strict caloric diet reduces visceral fat. In the end, if you put the weight back, diabetes will come back, "she says.
"I put people on a very low calorie diet that would be about 800 calories a day," she says, adding some people can stay on this diet for a year depending on the weight they're putting on. have to lose.
Orsmond worked with patients who reversed their diet by losing up to 13 stones a year, or as little as She said, she found, that those who were successful in reversing their diabetes and get out of drugs by losing weight, often fight for
"You have to change your eating habits and continually monitor the diet," she says. "It is almost impossible for a type 2 diabetic patient to lose weight while he is taking diabetic medications because a side effect of many of these medications is gaining weight," she says.
It is crucial, she says, that a patient on diabetic treatment begins his fast under strict medical supervision when his medication is adjusted by his doctor.
Diabetes? "Maintain a normal weight," advises Orsmond, who plans to add to its clinics in Dublin and Galway a new service based in Cork in September.
"It's about maintaining a healthy weight. Most people today have too much energy to eat too much, "she says, adding however that it is very difficult to maintain a normal weight in the world today. ; hui.
"You have to work hard to maintain your weight, not to mention lose it. You must reduce your overall caloric intake for a long time, and then maintain a completely different way of eating.
PREVENTING the onset of type 2 diabetes is a matter of diet, stresses nutrition consultant Gaye Godkin
"The focus should be on the nutritional composition of the plaque rather than on the total caloric plate, "she adds, adding that she is not in favor of the very strict approach of weight loss controlled by calories. According to her, what we need to do is educate people to navigate and negotiate their food environment, because "89% of people who lose weight" take it back
. "Exercise is one of the best ways to manage and treat type 2 diabetes because it regulates upward receptors on cells that take glucose." The diet is the other My catch is to cut out simple carbohydrates like bread, cookies and cakes, to ensure the diversity of proteins and fibers that promote intestinal health, because type 2 diabetes is hugely linked to intestinal health. the key to preventing type 2 diabetes.
"A diet high in processed meat puts the consumer at a higher risk of type 2 diabetes."
People need good fats and must learn to become healthy
"I am not a fan of people who use milk shakes as substitute foods, unless they are sick or hospitalized or if they are older." In essence, they may have a short-term effect but they certainly are not the solution to treat it. Whether they are prescribed or not, this is not a healthy long-term solution. Patients must change their relationship with food. "
Diabetes Ireland recognizes that low-calorie diets have a role to play in rapid weight loss over short periods of time, but, warns the medical director of the organization, Dr. Anna Clarke, should be aware of two things – such diets should always be done under medical supervision and that a calorie intake of about half the normal recommended caloric intake for adults poses a variety of challenges for the participant. These include interacting with others in social situations where food is consumed, or in terms of having enough fuel in the body to exercise enough, while daily interactions with others can become difficult because high levels of ketone result from low calorie diets.
"In addition, people may experience headaches and other symptoms as a result of it some substances, hence the need for medical supervision, "she adds.
Therefore, anyone newly diagnosed with type 2 diabetes, who has a lot of weight to lose – and the motivation to lose it – should seek medical support before adopting a low-calorie diet, advises Dr. Clarke .
"For all diabetics, consider a target weight loss of 5%, and if possible 10% and do it through a healthy diet with increased physical activity.
"Most of us underestimate our caloric intake of food and overestimate the
My body started working with me
At the end of April, Mary *, a business woman of about forty years old who had been diagnosed with type 2 diabetes several years ago and who was taking medication After several years of struggle to lose weight and try to In response to a growing diversity of diabetes medications, she felt that nothing helped her, and finally her feet began to go numb, which led her to take more medicine. [19659003"IwasalwaystiredandmybloodsugarlevelwbadtillhighandthedrugdidnotseemtohaveanyimpactonitShewasfinallyhospitalizedafterhavingabadreactiontoanewtablet
Disillusioned, she decided to follow a low calorie diet of about 800 calories a day
. pounds in the first two weeks and up to now have lost nearly a stone and a half. My blood sugar levels, which were very high while I was taking the medication, are now lower than they have been in years.
"I do not take any medicine. I find the low calorie diet really good. It's as if my body had started working with me. I feel good, I found my sense of humor, my energy level is 100% better and I am very active.
"I have been on a diet for about two months and it seems to be working much better than the drug has ever done.The numbness of my toes also fades away."
* This n '# 39; is not his real name
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