We live in the 'Age of Adiposity', caused by several different factors involving the western lifestyle, which are fuelling the current Diabetes epidemic. Currently 25% of New Zealanders are thought to be in the pre-diabetic stage ( Hba1c levels between 40-49) but aren't aware of it. Predictions for the USA suggest 1 in 3 people could have Diabetes by 2030. Increasingly we are seeing children being diagnosed at younger ages with obesity and type 2 Diabetes here in New Zealand. These are worrisome statistics.
But there may be light at the end of the tunnel. If you are motivated and committed. The Listener ran an article about Prof Roy Taylor from the Diabetes research unit at the University of Newcastle upon Tyne in the UK, who has just published a small trial showing Type 2 Diabetes can be reversed with weight loss and decreased fat in the organs, particularly the pancreas. Trials had already shown that obese patients given a gastric bypass who lost a significant amount of weight had restored normal blood glucose levels and many could eventually come off Diabetes medication. This trial involved just 11 patients who had been diagnosed with Type 2 Diabetes for upto 4y. They were put on a very low calorie diet for 2 months and all lost weight and all reversed their diabetes. He hopes to run a larger trial soon with funding from Diabetes UK.
I was interested to read this, as I have observed the same effect with my patients who enter the 'gray zone' of prediabetes but manage to make some lasting lifestyle changes and put their Hba1c (pre-diabetes test) back in the black. I have also had a few type 2 Diabetic patients who have lost a significant amount of weight and discarded their Diabetes diagnosis in the process.The mechanism is a complex interplay of metabolic hormones, but to simplify , losing fat reduces our insulin levels and improves our insulin sensitivity. There may also be a mechanical issue with the excess fat being laid in the pancreas literally 'clogging ' it up and reducing insulin production, according to Prof Taylor.
The impact on insulin efficiency with excess body weight varies from person to person, and it is possible to appear slim on the outside but to have accumulated excess fat in the organs on the inside. Draining fat from the organs seems to be a major factor in improving function. Very low calorie diets aren't necessarily the only way to do this, and can be dangerous if not properly supervised. Far better is to adopt longterm nutrition choices and improved exercise, and address stress levels.
Another word of warning- the studies mentioned only looked at Type 2 Diabetes; there are other types of Diabetes which have a different underlying mechanism and which we cannot apply the same reasoning. Also if you are a type 2 Diabetic and contemplating making some changes to your lifestyle, please see your doctor first for individualised advice.
Prof Taylors website details are as below: