Here’s another way to reverse Type 2 Diabetes (E. L. Lim, K. G. Hollingsworth, B. S. Aribisala, M. J. Chen, J. C. Mathers, R. Taylor. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia, October 2011, Volume 54, Issue 10, pp 2506–2514). Here were the subjects:
Eleven people with type 2 diabetes (49.5 ± 2.5 years, BMI 33.6 ± 1.2 kg/m2, nine male and two female) were studied before and after 1, 4 and 8 weeks of a 2.5 MJ (600 kcal)/day diet.
Here are the results:
After 1 week of restricted energy intake, fasting plasma glucose normalised in the diabetic group (from 9.2 ± 0.4 to 5.9 ± 0.4 mmol/l; p = 0.003).
Insulin suppression of hepatic glucose output improved from 43 ± 4% to 74 ± 5% (p = 0.003 vs baseline; controls 68 ± 5%).
Hepatic triacylglycerol content fell from 12.8 ± 2.4% in the diabetic group to 2.9 ± 0.2% by week 8 (p = 0.003).
The first-phase insulin response increased during the study period (0.19 ± 0.02 to 0.46 ± 0.07 nmol min−1 m−2; p < 0.001) and approached control values (0.62 ± 0.15 nmol min−1 m−2; p = 0.42).
Maximal insulin response became supranormal at 8 weeks (1.37 ± 0.27 vs controls 1.15 ± 0.18 nmol min−1 m−2).
Pancreatic triacylglycerol decreased from 8.0 ± 1.6% to 6.2 ± 1.1% (p = 0.03).
Other interesting factoids from the study. In Type 2 diabetics:
Beta cell function declines linearly with time, and after 10 years more than 50% of individuals require insulin therapy.
Here’s the data from the study.
| Variable | Controls | Baseline | Week 1 | Week 4 | Week 8 |
|---|---|---|---|---|---|
| Weight (kg) | 101.5 ± 3.4 | 103.7 ± 4.5 | 99.7 ± 4.5* | 94.1 ± 4.3 * | 88.4 ± 4.3*† |
| BMI (kg/m2) | 33.4 ± 0.9 | 33.6 ± 1.2 | 32.3 ± 1.2* | 30.5 ± 1.2* | 28.7 ± 1.3*† |
| Fat mass (kg) | 36.2 ± 2.7 | 39.0 ± 3.5 | 36.6 ± 3.6 * | 31.7 ± 3.7 * | 26.3 ± 4.0* |
| ffm (kg) | 64.7 ± 3.8 | 64.7 ± 3.0 | 63.2 ± 3.1 | 62.4 ± 3.0 * | 62.1 ± 3.0* |
| Waist circumference (cm) | 105.0 ± 1.5 | 107.4 ± 2.2 | 104.4 ± 2.2* | 99.7 ± 2.4 * | 94.2 ± 2.5*† |
| Hip circumference (cm) | 109.8 ± 2.4 | 109.5 ± 2.9 | 108.3 ± 2.7* | 105.0 ± 2.6* | 99.5 ± 2.6*† |
| WHR | 0.96 ± 0.02 | 0.98 ± 0.02 | 0.97 ± 0.02 | 0.95 ± 0.01 | 0.95 ± 0.01 |
It is remarkable that the people lost mostly fat. The Fat Free Mass loss was only 2.6kg (about 6 lbs). The fat loss was 10 kg (about 22 lbs). That’s a pretty decent drop.
Low Carb?
This was neither a Low Carb nor Low Fat diet. It was a restricted calorie diet (600 calories a day). The macros were 46.4% carbohydrate, 32.5% protein and 20.1% fat; vitamins, minerals and trace elements; 2.1 MJ/day [510 kcal/day]; Optifast; Nestlé Nutrition, Croydon, UK. This was supplemented with three portions of non-starchy vegetables such that total energy intake was about 2.5 MJ (600 kcal)/day.
It is remarkable how much fat was lost from the liver in just the first week.
Hepatic triacylglycerol content decreased by 30 ± 5% during week 1 of intervention (p < 0.001), becoming similar to control values (p = 0.75). It continued to decline throughout the intervention period to reach the normal range for non-obese individuals [20] (2.9 ± 0.2%; p = 0.003; Fig. 1), i.e. a total reduction of 70 ± 5%.
Most interestingly, the study after the study noted:
Following the intervention, participants gained 3.1±1.0 kg body weight over 12 weeks, but their HbA1c remained steady while the fat content of both pancreas and liver did not increase.
The conclusion matches my own hypothesis:
The data are consistent with the hypothesis that the abnormalities of insulin secretion and insulin resistance that underlie type 2 diabetes have a single, common aetiology, i.e. excess lipid accumulation in the liver and pancreas.
