Diabetes 2: you call this “news”?
A new study indicates that—at least in white Brits—losing a significant amount of weight can put Type 2 (used to be known as “adult onset” although it’s not completely limited to adults) diabetes into remission:
A clinical trial involving almost 300 people in the UK found an intensive weight management program put type 2 diabetes into remission for 86 percent of patients who lost 15 kilograms (33 lbs) or more.
“These findings are very exciting,” says diabetes researcher Roy Taylor from Newcastle University.
“They could revolutionise the way type 2 diabetes is treated.”
This is extremely puzzling to me. I thought weight loss had been the gold standard for years—for decades—in treating this type of diabetes (type 1 is different, both in its mechanism and in the demographics of its victims). Of course, some people get Type 2 diabetes without being overweight, but for the most part its sufferers are overweight and weight loss usually helps either somewhat or dramatically.
I’ve known this for many decades, probably at least since the 1970s. My father was diabetic, and he died in the 70s, and I remember it all rather well. So what gives?
It’s long been known that weight loss helps Type 2 diabetes, but it’s also long been known that weight loss is hard to achieve and much harder to maintain. This study is fairly new and the followup will be interesting for that reason.
[NOTE: If this thread is anything like previous ones that deal with the subject of weight loss, the Taubes and low-carb folk will come onto the thread saying how that’s the solution for everyone. It’s not, and I’ve written on the subject many times. Please do a search on the blog for “Taubes” if you want to get my opinion on that, but here’s one example.]
I’m going to address your note. I recently read about a study in ScienceNewsDaily that tracked rodents (I think) with different genetic profiles. They fed them different calorie restricted diets. The results suggest that different diets associated with weight loss had a genetic component to it.
So different rats lost a different amount of weight on different diets. No one diet worked the same for all subjects. I thought of you!
Thanks, Julia!
I definitely believe that people react very differently to diets.
Just for fun, I was looking for a clip of James Cagney saying “You dirty rat!” to illustrate, and I discovered he didn’t actually say that, although he said something similar. But what a great actor he was, particularly in those early gangster roles! Here’s the clip:
My cynical guess as to why these researchers recycled some very old news, is that this an attempt to prop up the U.K.’s financially crumbling free healthcare system.
In the U.S. the control of our system is largely in the hands of insurers and drug companies. Got a diabetic issue? Try our new inhaler system. And many of these things are effective and tend to be followed in Europe. But they cost money.
So if the system is bankrupt in the U.K., then they tell the patient to lose 30 pounds. Zero cost! Woohoo! And it is brand new research; the latest in healthcare. If the patient can’t make the weight, it’s their problem.
Managing diabetes is all about managing insulin. Almost every human body is stimulated to produce insulin after ingesting simple carbohydrates, especially what is commonly classed as “sugars”, and to a varying degree with complex carbohydrates, especially those unaccompanied by large amounts of fiber and fluid.
Fats and proteins in appropriate quantities suppress or fail to stimulate insulin production. Avoiding or minimizing carbohydrates (especially simple carbs) while taking in the right proportions of fats and protein consistently result in more manageable diabetic conditions. Most patients at the same time experience weight loss.
We have many years of monitoring patient responses in managing their diabetic conditions and the evidence is compelling.
I read that article today before neo’s post. My best friend has type-2 diabetes, so I’ve got skin in the game too.
Yes, it’s old news that losing weight is a standard approach to treating diabetes. My friend has certainly heard that often enough.
My impression is that the new news here is the high rates of remission (as opposed to improvement) with a specific dietary regimen demonstrated in a scientific paper. Hopefully its results are replicable and will lead to further work to help diabetics not just get by but put diabetes behind them.
Lose weight–Since you can’t increase the size of your pancreas to produce more insulin you can decrease the size of your body to require less insulin.
JFM:
Gee, wish it were that simple for overweight people.
It has been proven time and again that it is extraordinarily difficult to lose weight and keep it off, whether a person has diabetes or not. If you’re not aware of this, read the vast literature on it, and learn that it is not a mere failure of will, either.
Neo: This is not a comment regarding the advisability of using a lower carb diet for all people in all circumstances—something you rightly reject. However, I do not think that you are giving the low-carb science its due. Diabetes is a metabolic disorder that consists of the body’s inability to correctly regulate blood glucose—which in turn is almost completely related to how much carbohydrate you eat. I have Type 2, and that means that when I eat carbohydrates, my body converts to glucose as it should, but then cannot use the blood glucose. So I should give my body MORE carbohydrates? That’s the ONE THING that is wrong with my metabolism—it cannot process carbohydrates!
RigelDog:
I don’t for a moment question low-carb diets as a treatment for diabetes. That’s been the recommendation as far back as I can remember.
I question them as a one-size-fits-all way to lose weight for people who have diabetes or don’t have diabetes.
Neo, I truly wish that a low-carb diet was recommended for diabetics, but that’s usually not the case. In fact, it’s only in the last I believe 2-3 years that the American Diabetes Association changed their position on this. They now say that a low carb diet CAN help some people. I struck up a conversation with a man working in our local pizza parlor, asking him if he was limping because his hip was bad. He said no, his foot is doing very badly and he has a lot of neuropathy due to Type 2 diabetes. BTW he is tall and thin and in his 50s. He has had no luck controlling blood sugar with medication and his A1C is in the 13s, which is terrible. I felt so bad for him and told him my story of success in controlling blood sugar and also cholesterol with low carb eating. His dietician has advised him to ingest 40-60 carbs per meal, which is basically a typical American carb heavy diet. He has literally never heard of eating low carb to stop high blood sugar.
RigelDog:
That’s not what I mean by “low-carb.” What you’re describing is very-low-carb.
To clarify: I know about what diabetics have been supposed to eat because my father was diagnosed with diabetes (type 2) in the 1960s. That’s a long time ago. He was supposed to follow the typical diabetic diet of the era (which I also had read about), which limited carbohydrates, particularly refined ones, quite rigidly but not to the extent of an Atkins type very-low-carb diet.
The diet was no sugar, little bread, limited rice and/or potatoes, limited fruit. Just not as limited as very-low-carb. But it absolutely was low carb compared to any “normal” American diet of that era or this era. And I think it remained the recommended thing to do right up till the present, and I believe it had been recommended for diabetics for many years even before the 60s when my father was diagnosed.
If that man you spoke to had never heard of the sort of diet my father was told to follow, his health care providers were negligent. It’s been recommended for at least 50 years and perhaps longer.