Intense Calorie Restriction Helps Fight Type 2 Diabetes

Type 2 diabetes is known to be relentless and progressive, resulting in complete and irreversible failure of insulin-producing beta cells of the pancreas. This study attempted to investigate whether calorie restrictions can prevent and reverse the failure of beta cells. Insulin resistance is an important marker of type 2 diabetes. This study thus evaluated whether insulin resistance could also be reversed through dietary modifications. The results showed that diet restriction could successfully reduce the blood sugar after a week of commencement. It was also noted that liver triacylglycerol levels decreased through diet restriction, while the sensitivity to insulin increased.

It is known from scientific evidence that type 2 diabetes is a progressive disorder, and may eventually lead to failure of the insulin-producing beta cells of the pancreas. Studies have shown that nearly half of the patients with type 2 diabetes suffer from failure of the beta cells after 10 years of the disease, thereby needing insulin supplementation through daily injections. Patients with type 2 diabetes are susceptible to the development of resistance to insulin. This means that their bodies are not able to function normally at optimum levels of insulin, and require higher levels of it, which is administered through injections. This study attempted to see if diet restrictions could create a negative balance in energy that may reverse insulin resistance and beta cell damage in those suffering from type 2 diabetes.

* For this study, 11 patients with type 2 diabetes (nine men and two women) were selected. The average age of all the participants was 49.5 years and all of them were reported to be obese after an assessment of their height, weight and body mass index. Eight healthy individuals were chosen as controls.
* The participants were given a restrictive diet of 600 calories per day and were assessed after the first, fourth, and eighth week from the start of this diet.
* Parameters like blood sugar, total glucose output from the liver, insulin sensitivity, and functions of the beta cells were measured. Using Dixon magnetic resonance imaging, levels of triacylglycerol were measured from both the liver and the pancreas.

Key findings
* It was found that after a week of diet restriction, the levels of blood sugar decreased from an average of 9.2 to 5.9 mmol/l in the patients with type 2 diabetes.
* The results also revealed that the glucose output from the liver was suppressed, indicating improvement in insulin sensitivity from an average of 43 to 74 percent in patients with diabetes, and 68 percent in the non-diabetics.
* Levels of triacylglycerol in the liver fell from an average of 12.9 to 2.9 percent in diabetics after the eighth week of study. Similarly, triacylglycerol levels in the pancreas fell by an average of 8 to 6.2 percent.
* Furthermore, sensitivity to insulin rose in both the diabetics and non-diabetics. The maximum response to insulin was seen at after the eighth week of study.

Next steps/Shortcomings
A very small sample of participants was studied and further trials on a larger population are necessary to derive conclusions that are more concrete. The participants were mostly those who had developed diabetes within four years prior to the study. Thus, the extent of damage to the beta cells may not have been adequate. Further studies with longer standing diabetics may provide a clearer picture. In addition, the participants were allowed to return to their normal diet at the end of 12 weeks. The effect of this return on the insulin sensitivity and blood sugar parameters should be considered in future studies.

This is the first study to show that damage to beta cells and decrease in insulin sensitivity can be reversed by severe calorie restrictions in the diet. The change is associated with the lowering of triacylglycerol levels in the liver and pancreas. The authors of this study speculate that this study will help in a proper assessment of the exact pathology of type 2 diabetes, allowing researchers to understand the cause of insulin resistance in populations. According to the authors, this study “carries major implications for information to be given to newly diagnosed patients, who should know that they have a potentially reversible condition and not one that is inevitably progressive.”

For More Information:
Reversal of Type 2 Diabetes: Normalization of Beta Cell Function in Association with Decreased Pancreas and Liver Triacylglycerol
Publication Journal: Diabetologia, June 2011
By E. L. Lim; K. G. Hollingsworth; Newcastle University, Newcastle, England

*FYI Living Lab Reports Are Summaries of the Original Research.

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