People with type 2 diabetes can not only normalize their blood sugar, but can undo some of the tissue damage that leads to the disease, according to a provocative new study published this month in Diabetologia.
Previous research trials have demonstrated that you can go into remission from type 2 diabetes, but conventional wisdom has been that the hormonal changes leading to diabetes are progressive, and only go in a single direction – getting worse.
In this study, a group of 11 recently diagnosed (< 4 years ago) type 2 diabetics under the age of 65 ate a 600 calorie diet for 8 weeks. This diet was largely made up from a liquid nutrition product called Optifast, but also included 3 servings of vegetables per day.
On this very restricted diet, blood sugars returned to the upper end of normal ranges very quickly and remained there throughout the diet intervention. Hemoglobin A1c, the benchmark for measuring diabetes control in primary care clinical practice, also came down to a non-diabetes range. But that’s not what makes this study newsworthy.
What got my attention was that measures of insulin resistance and pancreatic production of insulin -the two problems that co-exist in type 2 diabetes patients - both improved during the study. I have seen studies demonstrating the first improvement, but as far as I had been aware, pancreatic function has not been shown to significantly improve with a diet change alone.
Previously, loss of insulin production by the beta-cells of the pancreas has been considered to be progressive and irreversible. Even the term we use to describe this phenomenon, beta-cell burnout, seems to highlight this belief. If other research groups can confirm this finding, it truly will represent a paradigm shift in our understanding of diabetes management.
This study reminds me of the research published by Dean Ornish in the early 1990s – research that helped drive my interest in natural health as a career. Prior to Dr. Ornish’s study, atherosclerosis and heart disease were similarly seen as a one-way street. You might at best slow down progression, but once started, there was no way back. Since 1990, we’ve seen other diet and pharmaceutical interventions similarly reverse atherosclerosis to one degree or other, but until it was demonstrated once, noone even knew we should try.
All that said, we should probably not get too excited about this first study. It’s a small group, it’s all people with early onset diabetes (so not that much pancreas damage), the diet is so restrictive as to not be sustainable, etc. Still, if it is possible that the pancreatic changes that occur with diabetes can be reversed, maybe the next step is to see what happens with a more balanced and holistic approach.
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