Can Diabetes Be Cured? The Case for Type 2

As of today the prevailing wisdom is that there is no cure for diabetes, whether it is type 1 or type 2. However, it is known that in the case of type 2, following treatment, diabetes has actually been seen to go into remission in some patients. Although this may not be an outright cure, it surely gives hope that one day, a cure would be found that would do away with diabetes altogether. Some of them will be mentioned in this article.

But first, what is the evidence to show that Diabetes can indeed be reversed. Well first, it has been found that in people who qualify for bariatric surgery, that after surgery these individuals tend to quickly have their blood sugar level return to normal. Although there are some associated risks with the surgery and other post-surgery risks such as osteoporosis and nutrient deficiency, the benefits of the surgery, far outweighs the disadvantages.

The obvious and indeed often drastic improvement in patients' blood sugar status after this type of surgery and a dissatisfaction with the explanation offered by the surgeon, that it was due to the interference with appetite controlling gut hormones, led Doctor Roy Taylor of Newcastle University in 2011 to take action.

His own interpretation of why the surgery worked was that "(the surgery) led to a sudden shift of fat away from the liver and pancreas... " His approach was to using Type 2 diabetics investigate a low carbohydrate 600 calorie day diet which was calibrated to mimic the very sharp reduction in food intake after a bariatric procedure.

The diet was a liquid diet containing carbohydrate, vitamins, protein, fat, minerals and trace elements. "I predicted this could strip fat out of the liver and pancreas and both organs would return to normal - and our subsequent work has confirmed this.'

So what exactly was the study that Professor Roy embarked on that led him to confirm this. Well, it is known as the Newcastle case or diet.

In 2011 Roy Taylor and his research group at the University of Newcastle placed 11 individuals suffering from Type 2 diabetes and with a body index (weight corrected for height, the norm being 25kg/m2) of 33kg/m2 on an extreme 600 calorie liquid diet. This is supplemented by 3 portions of non-starchy vegetables a day which brings the total calorie intake to 800 calories per day for 8 weeks. Dramatically, less than a week thereafter, their blood sugar level fell from 9 to 6 mmol/l. Diabetes is said to be present when blood sugar is above 6.5mmol/l. and throughout the course of the study, it remained steady within the healthy blood sugar range.

In addition, their body mass index BMI graduated down from 33 to 29kg/m2, a direct reflection of a weight reduction from 101 to 88kg. Further it was found that this weight loss correlated greatly with a reduced amount of fat within the liver and pancreas. The result was that insulin quantity produced by the pancreas increased and the action of insulin on the liver was significantly improved.

In a corresponding second trial 54 year old Alan Tutty was able to successfully lose 26lb and reduce his weight to 13st 3lbs reversing his diabetes in the process.

Accordingly, the study did indeed prove that by a significant loss of weight, blood sugar levels in diabetes sufferers can fall and as such leave sufferers cured. This was in a controlled environment. What would happen in a non- laboratory environment? Could such an approach work in the real world. An opportunity soon presented itself.

Later that year, Richard Doughty was diagnosed with diabetes. Getting in contact with Prof Roy, he was encouraged to go on the diet. The diet consisted of the standard 800 calories and surprisingly less than two weeks (11 days) after, his blood sugar level had dropped to the non-diabetic 5.1mmol/l and he was on his next visit told by his GP "Your diabetes has resolved itself".

Nor was this just a fluke. Carlos Cervantes, 53 and from the US, already suffering from the ravages of the disease-failing kidneys and eyesight heard of Richards case and used the diet. He was able to reduce his weight from 120 to 80kg and reverse his diabetes. So too did Henry Cole, 67 of New Jersey, USA. Following the diet, he was able to reduce his weight to 70 from 81kg and his HbA1c level to 5.6% from 6.9%. And swinging back across the Atlantic again we have Steve Vincent, 58, from Southampton, England, who in December 2010 was diagnosed with type 2 diabetes. Following the diet with tenacity, he achieved success and was able to bring his weight down to 72 from 93kg and halve his HbA1c by bringing it down to 5.5% from a previous 10.7%.

Roy Taylors study and explanation for his results has been peer reviewed and corroborated by other scientists. One of these is Naveed Sattar, one of the UK's leading diabetes researchers and professor of metabolic medicine at the University of Glasgow. He said; if we consume more calories than we burn, we store the excess as fat. Among the places we store it are the pancreas and the liver, thus interfering with the former's capacity to produce insulin, and the latter's capacity to react to it. The effect of the extreme 600-calorie-a-day diet was to not only reduce body weight dramatically, but also to slash fat on the liver and pancreas. This then allows the pancreas to produce insulin and the liver to react to it.

But is this approach for everyone, and should you attempt it? Maybe not. Professor Roy was quick to point out that Type 2 diabetes only happens when a personal fat threshold was exceeded.

What this means is that depending on certain factors, BMI as it relates to your ethnicity, family history etc., some persons may be more predisposed to getting diabetes than others. That being the case, the amount of fat that a person can safely or should successfully try to lose may differ from one person to another. For example it has been found that some people with an apparently healthy BMI develop diabetes whilst others with BMIs in the 40s range do not.

Further, even with low BMIs people of South Asian descent can develop diabetes. As such it may be unsafe for one diabetic with a BMI less than 35 to attempt to lose as much weight as another diabetic of his weight class. Being of the same weight class does not automatically follow that their personal fat index will tally. Dr. Sattar elaborated on this "We're thinking it's about an individual's ability to make and store fat safely," he says. "Some people can store fat subcutaneously. With others, it goes straight to the liver and pancreas. That's the classic big waist, pot belly shape; the fat isn't distributed around the body." This explains why simple waist measurement - 37in or more for men, 35in for South Asian men, 31.5in for women - is now seen as a better risk indicator for diabetes than BMI.

In view of this, the sharp reduction in weight may not be for every body and it is best that one discusses it with one's doctor first before attempting to go on the diet. Though it is safe to say that losing weight within the general populations' normal range is a boon to good health.

The work continues though. The Newcastle study was in people who have type 2 diabetes of up to 4 years. Study is now being made to find out whether by a similar diet, people of longer duration diabetes could equally have their condition reversed. In a reply letter to questions frequently asked, Professor Roy Taylor continued that, "... there is good reason to believe that longer duration type 2 diabetes can be reversible, although after 10 - 15 years of diabetes it is likely that not everyone will be able to achieve a return to normal glucose control, despite major weight loss".

Whilst many are excited and bask in the euphoria of this apparent success against the disease, others demur, they opine that the true test of whether diabetes reversal amounted to a cure would depend on whether such patients can return to their old diet without hindrance. That is to say whether they can start eating anything they like again.

Well, while this may sound reasonable, it should be noted that the reversal of short duration Type 2 diabetes is premised on the individual's ability to free the pancreas and liver from excessive fat. As such where fat begins to build up again, the individual may just find him/herself sliding back into the maws of the condition.

On the obverse however (since fat build up in pancreas and liver is gradual) to contend that this automatically meant reversal did not constitute a cure would be to imply by a cure, a return to a pancreatic/liver health status the patient did not have immediately prior to the onset of the disease. In my humble opinion, in that light, reversal does constitute cure. In that very same light, it is neither safe nor expedient for such persons to return strictly to their pre-reversal diet. That indeed would be fool hardy.