A series of studies from Newcastle University in Newcastle upon Tyne, United Kingdom, starting in 2011 have supported this notion, including a new report published online August 2 in the journal Cell Metabolism. This current investigation examined reasons why substantial weight loss in some patients produces type 2 diabetes remission, which is a state in which most or all signs and symptoms of diabetes disappear. Using detailed metabolic tests and specially developed MRI scans, Dr. Taylor and his colleagues observed that fat levels in the blood, pancreas, and liver were abnormally high in people with type 2 diabetes. But after following an intensive weight loss program, all participants were able to lower these fat levels. As the fats decreased inside the liver and the pancreas, some individuals also experienced improved functioning of their pancreatic beta cells, which store and release insulin, a hormone that helps control blood sugar levels. The likelihood of regaining normal glucose control depends on the ability of the beta cells to recover, the study authors say. “Removal of fat from the pancreas was followed by insulin-producing cells returning to normal only in those people who became diabetes-free,” says Taylor. RELATED: What Is Nonalcoholic Fatty Liver Disease?
Building on a Prior Study Regarding Weight Loss for Reversing Diabetes
This current study from the scientists at Newcastle University built on results published in December 2017 in the medical journal The Lancet regarding the effects of weight loss on diabetes. In that investigation, about 46 percent of 149 individuals with type 2 diabetes who followed a weight loss program achieved remission, which the study defined as a hemoglobin A1C of less than 6.5 percent after one year. To lose weight, the participants in the intervention group consumed about 825 calories per day in liquid form for three to five months, then modified their diets to less extreme regimens intended to minimize weight gain. For these individuals, results improved according to the number of pounds shed — 86 percent of those who lost more than 33 pounds attained remission, while 57 percent of those who lost 22 to 33 pounds reached that goal. RELATED: Study Suggests Losing This Much Weight May Reverse Diabetes
Losing Weight Sooner Beats Later in Diabetes Reversal
Still, while many responded to the weight loss program and achieved remission, others did not. To better understand why, researchers focused on 29 responders who achieved remission after dieting and 16 nonresponders who dieted but continued to have diabetes. Taylor and his colleagues observed that people who were unable to restart normal insulin production had lived with diabetes for a longer time. Individuals who had lived with diabetes for an average of 3.8 years could not correct their condition through weight loss, while those who had it for an average of 2.7 years were able to regain normal blood sugar control. “Type 2 diabetes is a potentially reversible condition, but commencing successful major weight loss should be started as early as possible,” says Taylor. “Return to full health is possible especially after only a few years of type 2 diabetes.” RELATED: 5 Diabetes Weight Loss Mistakes and How to Avoid Them Joseph S. Galati, MD, a hepatologist with Liver Specialists of Texas in Houston, recommends weight loss as a means for diabetes control for his patients, and says that this study only underscores the importance of maintaining a healthy weight. Dr. Galati wasn’t involved in the current research. “In the realm of fatty liver disease, which is highly associated with either prediabetes or fully diagnosed type 2 diabetes, we do know that decreased fat and decreased weight are associated with far better glucose control,” says Galati, who is the author of Eating Yourself Sick: How to Stop Obesity, Fatty Liver, and Diabetes From Killing You and Your Family. “This research reinforces the idea that patients with type 2 diabetes who are obese — which is the vast majority — can improve their blood sugar control as well as their long-term outlook with weight loss.” RELATED: The Best and Worst Diets for Weight Loss and Overall Health To drop pounds, Galati emphasizes using portion control, avoiding processed foods, and eating fresh vegetables, fruits, and fresh lean meat, poultry, and fish. Regular exercise should also be part of the program. Typically, he talks to patients about first targeting a weight loss goal of 10 percent. Once that is achieved, they typically strive for increments of 5 percent to 7 percent on a 6- to 12-month basis. “Everyone has to remember that this is a marathon, not a sprint,” he says. “With weight loss, you need to be patient and methodical.”
