Can losing weight get rid of diabetes?
New research1 from scientists in the United Kingdom suggests that remission of type 2 diabetes is possible through weight management.
The trial, led by Michael Lean, MD, of the University of Glasgow, included 306 overweight and obese people, ages 20 to 65, who had type 2 diabetes for a maximum of 6 years.
Half of the participants were randomly assigned to an intervention group that put them on a very low-calorie diet. The other half, the control group, received standard diabetes care but no specific guidelines to cut calories dramatically.
22 pounds lost
After one year, the intervention group lost an average 22 pounds. The control group shed just 2 pounds.
Type 2 diabetes in remission
And after one year, 46% of those in the intervention group were able to achieve remission of type 2 diabetes. Only 4% in the control group did.
Remission was defined as achieving an HbA1c (a measure of long-term blood sugar control) that was less than 6.5% without the use of medication for a minimum of 2 months.
Among those in the low-calorie intervention group, nearly a quarter shed 33 pounds or more, which was the study’s primary goal. None in the control group achieved such a weight loss.
More weight loss, more diabetes remission
The scientists found that the more weight lost, the greater the likelihood of diabetes remission:
Among those who gained weight: 0% achieved remission of diabetes
- For those who lost 0 to 11 pounds: 7% achieved remission
- For those who lost 11 to 22 pounds: 34% achieved remission
- For those who lost 22 to 33 pounds: 57% achieved remission
- For those who lost more than 33 pounds: 86% achieved remission
The need for long-term weight loss
“Our findings suggest that even if you have had type 2 diabetes for 6 years, putting the disease into remission is feasible,” stated Dr. Lean in a Lancet news release. “In contrast to other approaches, we focus on the need for long-term maintenance of weight loss through diet and exercise and encourage flexibility to optimize individual results.”
In an accompanying editorial2 in the same issue of The Lancet, Matti Uusitupa, MD, PhD, of the University of Eastern Finland described the trial’s findings as “impressive.” They “strongly support the view that type 2 diabetes is tightly associated with excessive fat mass in the body.”
This study, he continued, indicates that weight loss should be the top priority in type 2 diabetes treatment. A lifestyle-based, non-pharmacological approach should be revived, he wrote, because “antidiabetic drugs seldom result in normalization of glucose metabolism if patients’ lifestyles remain unchanged.”
It’s vital to keep the weight off.
“If you regain the excess weight, the diabetes will eventually return,” cautions Seth Marquit, MD, Medical Director of the Pritikin Longevity Center in Miami. Pritikin has been teaching healthy-living skills for the prevention and control of diabetes, high blood pressure, and heart disease since 1975.
“What’s driving the return of diabetes isn’t diabetes, per se. It’s something called insulin resistance.”
To better understand what’s going on in our bodies, let’s backtrack a bit with definitions of diabetes and insulin resistance…
What is diabetes?
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is made, stored, and released by cells in the pancreas called beta cells.
When our insulin is malfunctioning, sugar (also called glucose) builds up in the blood.
- A fasting glucose below 100 mg/dL is considered normal.
- A fasting glucose between 100 and 125 mg/dL signals prediabetes.
- A fasting glucose 126 mg/dL or higher means you have diabetes.
There are two main types of diabetes – type 1 and type 2. Type 2 diabetes is virtually entirely preventable. Worldwide, many populations are now suffering epidemic rates of type 2 diabetes because many live in a food toxic and sedentary environment that leads to obesity.
What is insulin resistance?
Insulin resistance is the major precursor of type 2 diabetes. Insulin resistance means that your pancreas is producing insulin, but your body’s cells are resisting it.
Here’s what is happening. In a normal cell, insulin can open the cell’s “doors” and ferry glucose from the bloodstream into the cell, nourishing that cell. The medical term for “doors” is insulin receptors. They receive insulin.
Insulin resistant cells
In cells that are insulin resistant, most of the cells’ doors are shut tight. Insulin can’t get in, which means glucose stays in the blood, building up. The pancreas, determined to deposit that glucose into our cells, pumps out more and more insulin to “break” those cell doors down. That’s why people with prediabetes or diabetes often have high insulin levels.
But ultimately, the beta cells in the pancreas wear out. Insulin production stops, which is why people who’ve had type 2 diabetes for many years must often resort to insulin shots.
What causes insulin resistance?
The chief cause of insulin resistance is the diet we in America typically consume – super-calorie-dense stuff like sugary beverages, from sodas to smoothies to sports drinks, as well as CRAP (calorie-rich and processed) foods like pizzas, burgers, French fries, donuts, Doritos, and desserts. All these calorie-dense foods and drinks lead to weight gain and the build-up of body fat.
Getting blood sugar back to normal
The good news: When we shed the body fat, insulin often starts working again. That’s because our body’s cells often start working again. Their “doors” kick open when insulin comes calling. Once again, insulin can ferry glucose out of the bloodstream and into our cells. As a result, blood glucose falls into healthy, normal ranges.
Interestingly, you don’t have to shed a lot of weight before insulin gets back into gear.
“We’ve seen much improved insulin sensitivity for decades at the Pritikin Longevity Center, and it happens in just two to three weeks – long before people have lost much weight,” observes Dr. Jay Kenney, PhD, RD, educator and nutrition research specialist at Pritikin.
“It’s really encouraging. Losing weight may happen slowly, but getting healthy – getting rid of insulin resistance, getting your blood sugar down to healthy levels – can happen very, very quickly.”
Insulin resistance in remission
“Combating insulin resistance is incredibly important,” emphasizes Tom Rifai, MD, FACP, Regional Medical Director of Metabolic Health & Weight Management at Henry Ford Health System in Michigan, and member of the Pritikin Scientific Advisory Board.
“In fact, when we shed weight and get our blood sugar under control, it’s not really diabetes that’s in remission, it’s insulin resistance that’s in remission.”
Keeping diabetes at bay
The best way to keep insulin resistance and diabetes at bay is to keep the weight off.
The best way to keep the weight off is not by forcing yourself to live with chronic hunger day in and day out. “Chronic hunger is what happens with portion-control diets,” explains Kimberly Gomer, MS, RD, Director of Nutrition at Pritikin.
The problem with portion-control diets
“Portion-control diets often whittle down food to tiny, unsatisfying servings. Can anyone really stop at one skinny slice of pizza?” Eventually, nagging hunger overrides will power. Yes, the whole pizza disappears.
The best way to keep the weight off is with a program, like the Pritikin Eating Plan, that allows you to eat plenty of food throughout the day. It’s food that is low or moderately low in calorie density but high in stomach-filling satisfaction. It’s food like fruits, vegetables, bean-rich soups, potatoes, sweet potatoes, whole-grain pasta, and other plant-based, fiber-rich, unprocessed or minimally-processed foods. It’s food that fills you up on 10 to 20 calories per bite, not 100 calories per bite.
Concurs Dr. Tom Rifai: “It is far more likely that someone will maintain healthy weight reduction with these low- to medium-calorie-dense foods than with portion-control approaches that hyper-focus purely on calories. There’s another great bonus to these lower-calorie-dense foods. They’re often very high in nutrition.”
Getting off medication
“When you stick with a plan like Pritikin, you have a win-win situation. You’re not only losing the weight, you’re losing the medications,” adds Dr. Kenney.
“Here at the Pritikin Longevity Center, we’ve seen that most people with type 2 diabetes who have sufficient remaining beta-cell function are actually able to get off their diabetes meds.
“Bottom line: Insulin resistance is largely reversible with a healthy diet and exercise program provided it reduces calorie intake and leads to long-term weight control.”
Benefits of exercise
Getting into the habit of daily physical activity has also been found to reduce insulin resistance.
Of course, regular exercise also aids in the loss of body fat – and helps keep the weight off. In fact, one of the best predictors of long-term weight-loss success is a lifestyle that includes regular exercise.
Even if you regain the weight, keep trying
Yo-yoing? That’s okay. Keep at it.
“There is clear evidence that there is longer remission and better glucose control in people with type 2 diabetes who have lost weight and regained it compared to those who have never lost,” says Dr. Rifai.
“In short, it is better to have lost and regained than to have never lost at all.”
The sooner you get started, the better
In research3 on men and women with type 2 diabetes who came to the Pritikin Longevity Center, those who were most successful were those who arrived when they were first diagnosed with the disease, not those who waited till they’d had the disease for many years.
“The longer one continues treating type 2 diabetes with drugs while mostly ignoring what drives the disease process – excess body fat, excess calories, inactivity, and a lousy diet – the more rapidly the disease progresses. Beta cells are lost forever. It becomes more and more difficult to control blood glucose without drugs,” explains Dr. Kenney.
Beta cell burnout
To be sure, loss of beta cells happens to virtually everyone with type 2 diabetes. By the time people are diagnosed with the disease, many have already lost about half of their beta cells. It’s called beta cell burnout. Unfortunately, little evidence suggests that these burnt-out cells will ever function again.
“But with weight loss, you can maintain good functioning of the beta cells you still have,” encourages Dr. Kenney. “That’s why it’s so important to get started, now, with a healthy, weight-reducing program like Pritikin. Don’t wait.”
Summing Up | Can losing weight get rid of diabetes?
If you’ve been diagnosed with type 2 diabetes, there’s a good chance that adopting a program of low-calorie-dense eating and regular exercise, like the program taught at the Pritikin Longevity Center, will lower your blood sugar into healthy, normal ranges. That’s in large part due to the loss of insulin resistance.
When insulin resistance is in remission, blood sugar falls. When blood sugar falls, your need for medications falls.
In fact, research4 has shown that most people with type 2 diabetes who come to Pritikin on drugs for diabetes no longer need these drugs within 2 or 3 weeks, or their dosages have been dramatically reduced. Even some people who arrive using insulin shots no longer require them – or need less – upon their return home.
But always keep in mind that you’re susceptible to having your diabetes return.
The Pritikin Program protects you from that return. By sticking with a Pritikin lifestyle, you keep fat stores at bay, which keeps insulin resistance and diabetes at bay.
There’s more good news: With Pritikin living, you’re living well. You may never be able to say you’re completely rid of diabetes, but you sure feel as if you are.
Dr. William Pordy, a physician from New York City, knows that feeling. Several years ago, he arrived at Pritikin 60 pounds overweight and a type 2 diabetic. He shed that weight, and with it, his sky-high blood sugar numbers.
“Isn’t it terrific that at my age – I’m in my 60s – I actually turned my life around? Once you go to Pritikin, you learn, really learn, how to exercise and eat right. If I hadn’t gone to Pritikin, I wouldn’t have lost the weight, and I wouldn’t have gotten rid of my diabetes,” says Dr. Pordy.
“Oh sure, I’ll always be a type 2 diabetic, I’ll always need to live Pritikin-style to keep it under control, but that’s okay because I feel so good now. I’ve got energy. My brain functions better. My work functions better. Everything functions better. That’s why I can say I’ve gotten rid of my diabetes.
“I wouldn’t want to live any other way.”