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Crash Diet Is Cure For Diabetes --- The Times

 

BRITAIN’S 2.6m type 2 diabetics have been offered new hope after scientists found a short-term crash diet can reverse the disease and restore their natural insulin levels.
 
They found that putting overweight diabetics on a diet of just 800 calories a day cleared the disease and returned them to health in a few weeks.
 
So far the technique has been tested successfully on only 11 patients, but now it is to be the subject of a £2.4m medical trial involving 280 people with obesity-induced diabetes.
 
The hope is that the crash diet could provide a clinical treatment for GPs around Britain to use to tackle the epidemic of diabetes that costs the NHS about 10% of its entire budget.
 
Professor Roy Taylor, director of Newcastle University’s magnetic resonance imaging (MRI) centre, who led the initial study, said the early findings were “enormously exciting”.
“We demonstrated that by changing calorie intake we could change fat levels in the liver and pancreas and return insulin production to normal,” he said.
 
“The new study is to see whether GPs can use this approach to reverse diabetes in their patients and whether it will stay reversed. The evidence is that it will, but we need a large-scale trial to prove that it works.”
 
Type 2 diabetes, unlike type 1, is closely correlated with obesity. It occurs when the body cannot produce enough insulin, or the body’s cells do not react to insulin, a hormone secreted by the pancreas that moves glucose from the blood and into cells where it can be used for energy.
 
With insufficient insulin, blood sugar soars, with a raft of dangerous side effects. These include a sharply increased risk of heart attack and stroke, blindness, foot amputation and dementia.
 
Scientists already know that people who undergo weight-loss surgery such as gastric bypasses often see their type 2 diabetes go into remission, but such treatments are dangerous and seen as the last resort. The crash-diet approach is based on new evidence about the underlying cause of the disease, linking its onset to the depositing of fat around the liver and pancreas. In healthy people the liver should contain only about 2% fat, but in the obese this can exceed 40%, which, research shows, can suppress insulin production.
 
Taylor and his co-researcher Mike Lean, professor of human nutrition at Glasgow University, who will be jointly overseeing the new trial, used MRI scans to observe how crash dieting rapidly removes these particular fat deposits, potentially explaining why it gets such rapid results.
 
“The good news is that if you cut fat in the diet then the liver fat falls very rapidly — and that means the pancreas can start working again,” said Taylor.
 
Allan Tutty, aged 54, from Sunderland, saw his diabetes go into remission after starting the crash diet in November 2012. By January he had lost 2st 7lb and his diabetes was in remission.
 
He said: “The hunger went away after a few days, but the biggest issue was the boredom, because the diet is just milkshakes and vegetables. I also didn’t sit down with the family at meal times, and at Christmas all I had was a salad.”
 
For Tutty the effort was well worth it. “Being diagnosed with diabetes had a powerful psychological effect on me. I was told there was no cure and it would be with me for ever. I feel better now psychologically and physically.”
 
Taylor and Lean are encouraged by such success stories, but say far more data is needed to assess the potential.
 
In their new study 140 patients with obesity-related type 2 diabetes will be put on low-calorie liquid diets for 8-20 weeks. Another 140 will act as controls — getting the best modern treatments but without having to diet.
 
Once they have hit their target weight and come off the diet, the patients will be monitored for up to two years to see if they can avoid regaining the lost weight.
 
Lean said the crash diet would be tough for people to stick to. “We’re confident that some people with type 2 will be able to achieve remission because we’ve seen it happen before. But what we really want to know is: how many can do it and are we able to identify those for whom it is not worth making the effort?
 
“If our analysis shows this approach is both effective and cost-effective, our aim will be to produce a programme that can be implemented in the NHS as soon as possible.”
 
Anna Morris, head of research funding at the charity Diabetes UK, said the crash-diet approach was the most promising they had seen in years. “We are putting £2.4m into this new trial, making it the biggest study we have ever funded. If the results are positive then the impact would be huge, but we need to wait and see what the outcomes are.”

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