Simple lifestyle changes could be all you need to stave off this life-threatening condition or even reverse it…
THE news that Type 2 diabetes may be reversed by following a strict low-calorie diet was greeted as a beacon of hope for the millions of sufferers of this debilitating condition but using it as a “cure” still remains a long way off.
Type 2 diabetes is the most common form of the disease, affecting 2.3 million of the 2.8 million diabetes sufferers in the UK. It is caused by too much glucose in the blood due to the pancreas not producing enough of the hormone insulin which breaks down glucose in the cells or due to the body not reacting to it, which is known as insulin sensitivity.
Traditionally it has been thought to be incurable and progressive but a trial carried out by researchers at Newcastle University found the extreme eight-week diet, which involves taking in just 600 calories a day, left the majority of sufferers free of the condition just three months later as a result of prompting the body to produce insulin again.
The very low-calorie diet, which involves “meal-replacement” milkshakes and portions of non-starchy green vegetables, can remove fat which is clogging up the pancreas, allowing normal insulin secretion to be restored, explains Professor Roy Taylor who led the study published in the journal Diabetologia and funded by Diabetes UK.
Gordon Parmley, 67, from Stocksfield, Northumberland, who took part in the trial, was diagnosed with Type 2 diabetes six years ago.
“I had to control my condition with the diabetes drug gliclazide and tablets for my cholesterol,” he says. “When my doctor mentioned a clinical trial of an extremely low-calorie diet I thought I would give it a go as it might help me and other diabetics.
“I stopped taking my tablets and had three diet shakes a day and some salad or vegetables but it was very difficult and I’m not sure I’d have done it without the support of my wife who went on a diet at the same time.
“At first the hunger was quite severe and I had to distract myself with walking the dog, playing golf or doing anything to occupy myself and take my mind off food but I lost an astounding amount of weight in a short space of time. At the end of the trial I was told my insulin levels were normal and I no longer needed my diabetes tablets.”
However, with the trial involving just 11 people, Professor Taylor says more in-depth research is needed before it could be used as a treatment. In the meantime, other diabetes sufferers are advised not to follow such an extreme diet without medical supervision.
“To go down to as low as 600 calories a day it would be virtually impossible to get all the nutrients the body needs without the use of the specially formulated foods and drinks that the researchers used in the study,” explains Carina Norris of the Nutrition Society.
“People who tried it alone would end up being malnourished, feeling weak, tired and lacking in energy. They might also feel dizzy and suffer mood swings. To put it into context, 600 calories is just below the estimated daily requirement for a four-month-old baby. Most sensible slimming diets for adults come in at around 1,200 to 1,800 calories a day.”
The good news is that following any sensible calorie-controlled diet has a chance of reversing and certainly preventing diabetes, says Professor Taylor.
“I had one volunteer who was very keen to take part in our extreme diet. I explained it would take months to get all permissions necessary and nine months later, when I was able to let her know I was ready to start the trial, she had lost over 2st through her own dieting efforts and, on testing, no longer had diabetes. That is the approach I would advise.”
Also, research shows there is plenty you can do to reduce your risk of developing diabetes in the first place. Follow our tips:
1 Get a good night’s sleep
Poor-quality sleep raises the risk of diabetes according to researchers at the University of Chicago.
When deep sleep is interrupted it affects the body’s metabolism and reduces its ability to convert sugar into energy, heightening the risk of diabetes. Just three nights of disrupted sleep can have the same effect on the body’s ability to control sugar levels as putting on more than 2st in weight, the study found.
The finding is particularly relevant to older people whose sleep is usually shorter and of poorer quality than that of younger people.
Since the risk of Type 2 diabetes rises with age the US researchers say older people should take measures to improve their sleep quality.
2 Limit sugar and salt
It’s a myth that eating sweets gives you diabetes, says Carina Norris. “Diabetics can have a little sugary food provided it is part of a balanced meal.
“However it makes sense to swap sugary, low-nutrient foods for more complex starchy carbohydrates such as wholemeal bread, brown pasta and rice and porridge, with protein such as lean meat, poultry, eggs, fish low-fat dairy, pulses and plenty of fruit and vegetables,” she adds.
“Research from the University of Copenhagen has found this kind of diet helps control your waist measurement: one of the biggest predictors of your chance of developing Type 2 diabetes.”
Too much salt has been found to cause high blood pressure, another risk factor for diabetes.
“Look for foods lowest in salt, there is a lot of variation between brands,” advises Carina. “Although crisps and savoury snacks are predictable salt traps, bread, breakfast cereals, pasta sauces and ketchups are less obvious culprits.”
3 Measure your waistline
“A man is at risk of Type 2 diabetes if his waist circumference is 37in or more (35 for south Asian men) and a woman is at risk if her waist circumference is 31.5in or more,” says Deepa Khatri, Diabetes UK clinical adviser.
The most spectacular illustration of how weight loss can influence the risk of diabetes is the effect of laparoscopic gastric banding, a type of weight-loss surgery in obese people. The journal Diabetes Care found it rapidly decreases the risk of the disease.
You don’t have to resort to surgery – losing 5kg, even over several years, has been found to reduce the risk of diabetes by 50 per cent.
4 Eat regular meals
Eating irregular meals is linked with an increased risk of developing pre-diabetes, a condition in which people have blood glucose levels higher than normal but not high enough to be classified as diabetes, scientists at Sweden’s Karolinska Institute have found.
“This was regardless of what people were eating. The important thing was how often they ate,” says Carina. Eating three meals a day helps prevent you becoming ravenous, she explains.
“When ravenous you are most likely to give in to the temptation of a chocolate muffin or extra serving of ice cream, which in turn can lead to excess pounds, putting you at greater risk of Type 2 diabetes.”
5 Check out your family history
Studies of twins show genetics play a very strong role in the development of diabetes. If the condition runs in your family, don’t lose heart, just remember that it’s worth working particularly hard at prevention. If you are overweight and have a family history of Type 2 diabetes, book regular check-ups with the GP so that you stay on top of your blood sugar levels.
6 Go for a brisk walk
As little as 15 minutes a day of acute exercise can have a profound influence on preventing and fighting Type 2 diabetes, scientists at the University of Missouri have found.
Diabetes UK claims that even a brisk walk a day can help, as can simple lifestyle changes such as walking up stairs instead of taking the lift.
7 A Mediterranean diet
A diet containing fresh vegetables, oily fish and olive oil may cut the risk of diabetes by 83 per cent, according to research from the University of Navarra, Spain, that followed 12,000 men and women for more than four years.
Research leader Professor Miguel Martinez-González says the most protective parts of the diet include a high intake of fibre and vegetable fat, a low intake of trans fatty acids and a moderate alcohol intake.
“A key element is the abundant use of virgin oil for cooking, frying, spreading on bread and dressing salads,” he adds.
8 Eat more low-fat dairy
A natural substance found in milk, cheese, yogurt and butter could help to prevent diabetes, according to research at Harvard School of Public Health.
The study, which monitored 3,700 people over 20 years, found those who had a high level of the substance known as a trans-palmitoleic acid compound in their blood were 60 per cent less likely to develop the disease than those with low levels.
“This is an extremely strong protective effect, stronger than other things we know can be beneficial against diabetes,” says Professor Gökhan Hotamisligil, author of the study.
However Deepa Khatri warns that milk and dairy foods can be high in fat. “Choose lower-fat dairy foods,” she says.
9 Eat almonds
These nuts could help prevent diabetes, research conducted at the University of Medicine and Dentistry of New Jersey suggested last year.
The study found a diet rich in almonds may help improve insulin sensitivity and decrease LDL-cholesterol levels in those with pre-diabetes.
10 Spice up your life
A study by Columbia University found that turmeric can prevent Type 2 diabetes.
Meanwhile, US researchers at the Human Nutrition Research Center in Maryland found cinnamon could help prevent diabetes in people at risk because of their family history.
It is thought the spice contains compounds which help the body to use the insulin it produces more effectively. The study also found diabetics who add half a teaspoon of powdered cinnamon to their daily diet have lower blood sugar, cholesterol and blood fats. The levels increased again when the volunteers stopped taking the spice.
11 Eat brown rice
Eating two or more servings of brown rice per week is linked to a lower risk of diabetes, say scientists at the Harvard School of Public Health.
Milling and polishing brown rice removes most vitamins, minerals and also fibre which helps prevent diabetes by slowing the rush of sugar (glucose) into the bloodstream.
12 Put the kettle on
Tea and coffee drinkers have been repeatedly found to have a lower risk of developing Type 2 diabetes but the protection may not be down to caffeine since decaf coffee has the greatest effect, say researchers in medical journal Archives of Internal Medicine.
They looked at 18 separate studies involving nearly 500,000 people and the analysis revealed those who drink three or four cups of coffee or tea a day cut their risk by a fifth or more. The same amount of decaffeinated coffee had an even bigger effect, lowering risk by a third. When the authors combined and analysed the data, they found each additional cup of coffee consumed in a day cut diabetes risk by seven per cent.
Lead researcher Dr Rachel Huxley, from the University of Sydney, says compounds in coffee and tea including magnesium and antioxidants known as lignans or chlorogenic acids may be involved.