Research which could provide a definitive judgement on whether low-calorie diets should be offered as a treatment option to put Type 2 diabetes into remission is to start.

The £2.4 million research project funded by Diabetes UK will be carried out by researchers at Newcastle University and the University of Glasgow. It aims to answer the question of whether losing weight on a low calorie liquid diet and keeping it off using a structured, personalised support programme is a viable treatment for putting Type 2 diabetes into remission in the long-term.

Professor Roy Taylor, the lead researcher at Newcastle University, said: “We know that changes in calorie intake can produce changes in body composition that, at least in some people, can put Type 2 diabetes into remission. But this new study will evaluate how well people do using this approach and uncover problems that might be faced.

“We are exploring uncharted territory and along the way there will be challenges, details to unravel, and other questions to ask. But I believe this study will lead to a quantum leap forward in our understanding of how best to manage Type 2 diabetes.”

The trial

In the trial, GP practices across Scotland and Tyneside will recruit people aged 20-65 who are overweight and have been diagnosed with Type 2 diabetes in the last six years. Participants at half the practices will be allocated to receive the current best-available Type 2 diabetes care, while those at the remaining practices will receive a low-calorie liquid diet of just 800 calories a day, for between 8 and 20 weeks. Those who complete the diet will then be gradually re-introduced to normal food over the next two to eight weeks and will receive expert support to help them maintain their weight loss in the long-term.

As well as monitoring the long-term effects of the diet, some of the participants will have MRI scans, which will show researchers what is happening inside the body during the diet.

This will be the largest single research project Diabetes UK has ever funded in its 79-year history. It follows a study from 2011 that found that 11 people with Type 2 diabetes who spent eight weeks on a low-calorie liquid diet all saw their insulin production return to normal and their Type 2 diabetes put into remission. These findings backed up anecdotal reports and results from bariatric surgery to raise the prospect of transforming the way Type 2 diabetes is treated.

But because the 2011 study was designed to better understand the biological processes in the body and only followed its participants for a relatively short period of time, scientists do not yet fully understand the long-term effect of these diets. This is why a longer and larger study is needed to find out whether the benefits of following such a restrictive diet outweigh any adverse effects. Also, the 2011 study was carried out in a research setting and so it is unclear whether such diets can be transferred to a larger scale as part of routine GP care, where large numbers of overweight people with Type 2 diabetes are managed in the UK.

Because of these unanswered questions, Diabetes UK does not yet recommend low-calorie liquid diets to people with Type 2 diabetes. But the charity is confident that the new study will answer these questions and so give the NHS enough evidence to make a decision on whether low-calorie diets should be offered as a routine treatment option.

Dr Matthew Hobbs, Head of Research for Diabetes UK, said: “Type 2 diabetes will always be a serious health 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 worsens inevitably over time. The 2011 study and evidence from bariatric surgery has shown us that it can be put into remission. If we can do this safely, on a bigger scale and as part of routine care, then following a low-calorie liquid diet would be a real game changer in terms of reducing people’s risk of devastating health complications such as amputation and blindness.”

Read about the trial where diet reversed Type 2 diabetes from 2011

(Adapted from Diabetes UK press release)

published on: 10 October 2013