By Tracy Kelly
Can we put type 2 diabetes into long-term remission? It’s a question that’s asked often and to date we don’t have the answer – but that could all change within a few years.
That’s because Diabetes UK has recently awarded a £2.4 million research grant to look into whether losing weight – and keeping it off – through a low-calorie liquid diet is a feasible long-term treatment for putting type 2 diabetes into remission.
As part of the Diabetes Remission Clinical Trial (DiRECT) study, researchers will recruit 280 overweight people with type 2 diabetes and put them on two separate diets. This new trial follows a 2011 study that found that 11 overweight people with type 2 diabetes saw their insulin production return to normal and their type 2 diabetes put into remission after eight weeks on a low-calorie liquid diet.
Following the huge media interest in this study, many people with type 2 diabetes were interested in this approach. But as exciting as these findings were, the study did not focus on the effects of the diet in the long term and there is still much about low-calorie diets that we are yet to understand.
As part of the new trial, one group of 140 people will spend between eight and 20 weeks on a low-calorie diet of 800 calories a day – mainly nutritionally complete diet soups or shakes, plus ample fluids. Then, as normal food is reintroduced, they will learn how to change their lifestyles permanently.
The results of this group will be compared with an equal number in the second group, who will follow what is currently accepted as the best advice for weight loss and weight maintenance.
Both groups will be monitored for two years to study the long-term effects of their diets on weight. MRI scans will look at what’s happening inside their bodies during the diet.
The aim is to see whether the stress and effort of following a restrictive diet for several months is beneficial in the long run. After all, 800 calories is not a lot – people following such a diet are likely to feel hungry quite a lot of the time. Also, will they be able to stick to it for long enough for it to be successful? Even more fundamentally, this kind of diet is not an easy option or a ‘quick fix’ and people will still have to follow a healthy lifestyle afterwards to stop their type 2 diabetes coming back. It’s a fact that weight regain after liquid diets is common.
Type 2 diabetes will always be a serious condition, but perhaps it won’t always be seen as a condition that people have to manage for the rest of their lives – and that inevitably gets worse. If this study shows that low-calorie liquid diets can be used safely, on a bigger scale and as part of routine care, it could completely change what we know about type 2 diabetes and how it is treated by the NHS. It could also provide an accessible way to help people with this condition live longer, with a better quality of life and a reduced risk of serious health complications.