Sept. 17, 2018 — Peter Maher, a retired teacher in London, says weighthas been a long-term issue for him. But when it inched up even more a few years ago, his type 2 diabetes became more unmanageable. Soon after the scale read 245 pounds, he remembers catching a glimpse of himself in a mirror.
“I saw this great, fat person staring back at me,” recalls Maher, now 71. “That was my eureka moment.” Knowing he had to take action, he consulted “Dr. Google.”
He found a London doctor who had published research about how substantial weight loss can reverse type 2 diabetes. In late 2015, he emailed Roy Taylor, MD, at Newcastle University and said he’d like to go on the plan Taylor had devised. The response? “You and 20,000 others.”
Reversing Type 2
While doctors have known for years that weight loss can not only prevent diabetes but sometimes reverse it, recently Taylor has found new clues as to why.
Type 2 diabetes, he says, “is simply due to too much fat inside the liver and pancreas of people who happen to be susceptible to the fat-induced damage.” Losing a substantial amount of weight can kill off that fat, often allowing the organs to work again, including a return to normal insulin production by the pancreas.
Behind the Weight Loss Advice
In an earlier study, Taylor’s team assigned 149 patients to the strict weight loss program and another 149 to usual care such as treatment with medications. Most were diagnosed within the previous 6 years before the start of the study.
After a year, only 4% of the usual care patients had remission of the diabetes, but 46% of those on the weight loss program did. The more they lost, the higher the chances of reversal. While 7% of patients who lost less than 11 pounds went into remission, 86% of those who lost 33 pounds or more did, Taylor found.
In general, “remission” in diabetes means a person’s blood sugar levels remain normal. While some refer to this as a “cure,” diabetes is not a “one and done,” disease. That is, it could always return if the patient regains the weight or returns to unhealthy habits. In 2009, a group of diabetes experts wrote that “remission” is a term used when a person has normal blood sugar levels for one year without therapy or surgery.
The new research ties in with recent thinking among experts about what happens when type 2 diabetes develops, says Domenico Accili, MD, chief of endocrinology at Columbia University Vagelos College of Physicians and Surgeons. “We have been talking for some time, that in diabetes, primarily type 2, the insulin-producing [beta] cell is not dead but simply inactive,” he says. “If you put patients with diabetes on a diet, you can do marvels with their beta cells.”