This means that if remission is achieved, the insulin-producing capacity of the pancreas can be restored to levels similar to those in people who have never been diagnosed with the condition.

Lead researcher Professor Roy Taylor and his team from Newcastle University have also shown remission leads to an increase in pancreas size.

The research provides important insights into what happens inside the pancreas and the body after significant weight loss.

The second year findings of DiRECT, the landmark trial funded by Diabetes UK, presented earlier this week, demonstrated that remission of Type 2 diabetes through a very low calorie diet is possible for at least two years.

Now, this further in-depth study involving a subset of DiRECT participants has explored the link between remission and the function of beta cells in the pancreas. 

Beta cells re-activated

Professor Taylor and his team have found that beta cells begin working again in people in remission of Type 2 diabetes. The insulin-producing capacity of their pancreas is also restored to normal levels.

The speed at which beta cells responded to glucose improved very gradually over the first year after remission. It remained steady during the second year of the study. This was enough to keep blood glucose levels below the diabetes range. However, it was not quite as fast as in people who had never had Type 2 diabetes.

Professor Taylor, Director of Newcastle University’s Magnetic Resonance Centre, and co-primary investigator of the DiRECT trial, said: “This research provides real hope for people with Type 2 diabetes that they may be able to return to healthy blood glucose levels. We now know why the body can recover.

“The previous assumption that insulin-producing cells are damaged forever in people diagnosed with Type 2 diabetes has been shown to be incorrect.

“Provided that people can maintain the weight they have lost, and it doesn’t creep up again, remission could last for years. The implications for future health and happiness are huge.”

Despite similar levels of weight loss, improvements were not seen in DiRECT participants who didn’t achieve remission - their beta cells appeared to have lost the ability to recover.

In people without diabetes, beta cells in the pancreas are ‘switched on’ when food is broken down and levels of glucose in the blood begin to rise. In response, the beta cells produce insulin to help the body use glucose as fuel.

However, this process of responding to rising glucose levels and releasing insulin goes wrong in people with Type 2 diabetes. It is believed that beta cell function inevitably gets worse over time after Type 2 diabetes is diagnosed.

Crucially, results from this latest study suggest that – if remission is achieved – the insulin-producing capacity of the pancreas can be restored to levels similar to those  who had never been diagnosed with Type 2 diabetes.

Professor Taylor added:  “The number of people currently living with Type 2 diabetes make these important findings.

“But the time that a person learns that they have just developed type 2 Diabetes is critical: This can now be recognized to be a medical emergency. It’s clear that there is an important window of opportunity at the point of diagnosis.”

Information on the diet that can reverse diabetes including meal plans can be found on the Newcastle University Magnetic Resonance Centre website. 

Pancreas increases in remission

A further study from Professor Taylor and his team, also presented at the Diabetes UK Professional Conference this week, has found that the pancreas increases in size in people who are in remission.

The pancreas is often smaller than usual in people with Type 2 diabetes. After two years, study participants had lost a significant amount of fat from their pancreas and the organ had grown approximately one sixth in size. 

Taken together, these findings begin to shine a light on the biology behind remission.

Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: “We’re learning more about Type 2 diabetes remission every day, with new DiRECT results just this week showing that a low-calorie weight management programme can put Type 2 diabetes into remission for at least two years.

“Now, we can begin to build a clearer picture of the biology behind remission: why isn’t it yet possible for everyone? In time, we hope this vital evidence can be translated into benefits for as many people with Type 2 diabetes as possible.”