There has been much written in the news recently about the possibility of people being able to ‘reverse’ their diabetes by using certain diets but before looking at whether this is or is not possible it’s important to understand exactly what diabetes is in the first place. This is a condition where the blood sugar level is higher than normal.
Insulin is a hormone produced by the pancreas gland in the abdomen, and this controls the use of glucose (sugar) within the body. The blood sugar level will rise if the pancreas produces little or no insulin (Type 1 diabetes), or if the pancreas produces insulin, but it’s inadequate for the body’s needs and its effectiveness is reduced (Type 2 diabetes). Type 2 diabetes is undoubtedly related to factors associated with a Western lifestyle, since it’s most common in people who are overweight and who don’t get enough exercise.
There are different types of tablets used for treating Type 2 diabetes. Some of these increase the amount of insulin secreted by the pancreas, some increase the action of insulin in the body and others delay the absorption of glucose from the digestive system. Treatment for diabetes depends on the individual and so is tailored for each person with diabetes. Insulin injections are used in Type 1 diabetes and in some cases of Type 2, and increase the amount of insulin in your body and so bring down the blood sugar level.
Recent studies have shown that strict glucose control can significantly reduce or even stop complications developing in the future so this means keeping the blood sugar level as close to normal as possible. These studies have also confirmed the need for people with diabetes to reduce their risk of atherosclerosis (fatty deposits in your arteries), because if you have Type 2 diabetes, you have a four to five times greater risk of developing serious problems with your circulation that can lead to a heart attack or a stroke.
So, is it actually possible to ‘reverse’ diabetes? (And by this, most doctors mean achieving a very significant improvement in long-term insulin sensitivity). Well, not if you have Type 1 – you will need insulin for life. However, some early studies do suggest that in Type 2 diabetes, sticking to a diet known as a VLC (very low calorie) diet can achieve significant weight loss, reduce insulin resistance and allow people with Type 2 diabetes to reduce or even come off diabetes medication altogether.
However, this is most definitely not for the faint-hearted as it involves sticking rigidly to a 800kcal/day diet where 600 calories are made up from meal shakes and the rest from non-starchy vegetables. This is a punishing regimen and an extreme form of dieting and should never be considered without seeking medical advice first. It is also virtually impossible to continue long-term over months or years.
Why should VLC diets improve diabetes? One Newcastle study used MRI scans in people on these diets and found that the apparent reversal in their diabetes and improved diabetic control appeared to be linked to significant reductions in fat storage within the liver and pancreas.
The basic facts remain with Type 2 diabetes however – overweight is bad, normal weight is better. A lifelong commitment to a healthy lifestyle can be more effective than medication in many people with this problem but this is often very hard for people to do, or to stick with.