Imagine being able to stop testing your blood sugar levels, cease taking insulin tablets or give up injecting yourself, perhaps several times a day? Well, that’s the reality for many in trials, who have already lost weight in order to control their diabetes more effectively.
It was back in 2011 in the UK that the discovery was first made that losing fat around one’s pancreas could send diabetes type II into remission. It was called the Diabetes Remission Clinical Trial (Direct) and involved people with diabetes type II following a special supervised low-calorie diet.
Now an Irish association of health experts, the Irish Society for Clinical Nutrition and Metabolism (IrSPEN), has its own good news. They have found that remission is achievable by 50% of people living with type II diabetes if they can lose 15% of their body weight. This information is relevant to people with type II diabetes who have a BMI over 30. If you are 16 stone, for example, with a BMI of over 30, it would mean losing two and a half stone (34 lbs). Treatment in the trials included specialist diets, specialist medication and surgery.
“There is no single silver bullet,” says Professor Carel le Roux from IrSPEN, “but rather that multiple approaches have to be used to optimally treat patients who have complications of obesity.”
Not every patient responds equally, he says, but reversal of complications can be achieved. “In two out of 10 people with complications from diabetes, those complications can be reversed with the use of specialist diets, three in 10 with the use of medication and another five in 10 with the use of surgical treatments,” says Professor le Roux.
slash COST FROM €4,000 TO €500
It’s a “kill two birds with one stone” situation, with both the person and the taxpayer’s pocket benefiting, IrSPEN says. The person can have the joy of stopping or reducing the amount of medication they need, and this change will also mean that instead of their care costing the State €4,000 per annum it will only cost €500.
At present, the cost of treating all obesity-related diseases is approximately €1.16bn per annum. In Ireland, one in four adults are now obese and one in four children are overweight or obese, with 2,000 deaths attributable to obesity each year.
WHAT SPECIALIST DIET INVOLVES
Ah, yes, but losing weight is not that easy. What does the specialist diet involve?
The supervised Direct low-calorie diet of 800 calories a day for eight to 20 weeks, for example, involves having four soups or shakes each day. These have all the essential vitamins and minerals. The initial period of eight to 20 weeks is followed by a long-term programme of weight-loss maintenance, under supervision.
For others in the trials who had serious difficulty achieving and sustaining the required weight-loss, however, surgery was suggested.
In remission
This is what happened in Letterkenny woman, Laura Sloan’s case. She has experienced remission of diabetes since having bariatric surgery. Speaking to Irish Country Living, she talks about how serious her condition was prior to the treatment in July last year.
“I had gestational diabetes on my first pregnancy 16 years ago, and it happened again on my second pregnancy and never went away after,” she says. “By the time I had my third child, I was on insulin six times a day. Because of situational difficulties, I was comfort eating during those years also, so my weight spiraled. I managed to lose it in 2012, but it all piled back on again,” says Laura.
Because nothing was working for Laura on the weight-loss front, her doctors suggested that she try surgery. “I went for it straight away, because I was thinking: ‘How long is it going to be before I lose my eyesight or a limb because of diabetes?’”
Laura was also finding the injection and tablet routine tedious – and all the hospital appointments. For her surgery wasn’t a drastic move. “It was a case of ‘Tell me where and when’, because nothing was controlling my diabetes,” she says.
Since last summer, Laura has not needed insulin injections or medication, as her diabetes has gone into remission. “I have to take a multi-vitamin and a calcium tablet – that’s it,” she says.
She explains that she was on a pre-op 800 calories a day diet in order to reduce the size of the liver before surgery. Afterwards she went through stages of liquid diet, mash and finally onto solids.
“The majority of weight-loss happens in those first months and it just keeps gradually going down and down. It then levels out when you find out what you can eat a day and how full you get. It’s a learning curve. My BMI is now on the normal scale for the first time in I don’t know how long. I’m actually sharing my 14 year old’s wardrobe at the moment because I don’t have a thing to fit me.”
She is delighted that her diabetes is now in remission. “I’m glad that I am going to be able to watch my children grow up without that black cloud of diabetes type II hanging over me. I worry about them too, but it’s been an eye-opener for us all. We’re more active now, we’re into healthy eating and are more adventurous with cooking. Your taste buds change and you can’t eat the stuff you did before. No more fish-and-chip suppers for me. I’m just not interested in that anymore.”
Reversing pre-diabetes
John Kane is from Dublin and has been involved in clinical trials to lose weight.
“I have lost 15% of my body weight as part of a specialist multidisciplinary service, and my pre-diabetes has now been reversed,” he says. “My sleep apnea is also much better because of the weight loss, and I feel 10 years younger.”
SURGEON SAYS IT’S A POSITIVE MESSAGE
John Conneely is a consultant metabolic surgeon at the Mater hospital in Dublin. “European Obesity Day on 19 May last was an ideal opportunity to remind people that type II diabetes can go into remission if the person is able to lose 15% of their body weight (if BMI over 30),” he says.
“This is a really positive message to people living with the condition to consider all of the options available to support them with this goal – including diet, exercise, medication and surgery. A lifetime dependency on medication can be removed.”CL
HOW THE BREAKTHROUGH HAPPENED
Diabetes UK announced a breakthrough on 6 November 2017, in using a low-calorie diet to put type II diabetes into remission in some people.
This study, called the Diabetes Remission Clinical Trial (Direct) had reached the end of its first year of trial and 45.6% of those who followed a low-calorie diet, under the supervision of a GP, had put their type II diabetes into remission.
Weight-loss was a key factor. In all, 86% of people who lost more than 15kg on the programme were in remission after a year, as were 57% of people who lost 10kg to 15kg, and 34% who lost five to 10kg. The low-calorie diet of 800 calories a day mentioned previously was used followed by supervised maintenance. Remission is defined as blood glucose (or blood sugar) levels returning to the normal range.
However, Diabetes UK and Ireland warn: “This doesn’t mean diabetes has gone for good. It’s really important for people in remission to get regular healthcare checks, so any complications can be monitored and any signs of type II diabetes coming back can be caught early.”
warning: DON’T GO IT ALONE
Following a low-calorie diet to put type II diabetes into remission is not a quick-fix, it is very challenging and it is not recommended to try this alone, Diabetes Ireland also says.
Anyone with type II diabetes considering losing weight in this way needs to discuss it with their GP and dietitian to get tailored advice and support.
If a person is taking medications that has a risk of low blood glucose levels (hypos), sulphonylureas or insulin, they will need to consult with their GP, as their medications will need to be adjusted as the weight-loss continues.
It would also be necessary to monitor the blood glucose levels more closely at home and keep a watchful eye for hypos.
Participants of the study needed the ongoing support and advice of experts to gradually re-introduce normal food into their diet and get support to help them maintain their weight-loss in the long term.
DIABETES IRELAND comment
Diabetes Ireland’s UK counterpart, Diabetes UK, has committed extra funding to investigate the possibility of delivering this type of treatment through the public health service.
“In light of this, we would urge the HSE to consider investing in planning a similar intervention to fund and resource GP care teams to deliver such a programme, and improve the quality of life for thousands of Irish people with type II diabetes,” Diabetes Ireland said.
Diabetes in numbers
• According to the WHO, 65% of the diabetes burden, 23% of the heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity.• Savings are expected after three to five years of these new treatments being offered, IrSPEN believes.• If you are living with type II diabetes and obesity, it is a good time to re-engage with your medical team to discuss ways that
you might achieve 15% weight loss through diet, exercise, medical or surgical treatment.FOR MORE INFORMATION
Information available on www.europeanobesityday.eu
To find out more about the weight-loss diet, visit http://bit.ly/2fiDdy5.
Imagine being able to stop testing your blood sugar levels, cease taking insulin tablets or give up injecting yourself, perhaps several times a day? Well, that’s the reality for many in trials, who have already lost weight in order to control their diabetes more effectively.
It was back in 2011 in the UK that the discovery was first made that losing fat around one’s pancreas could send diabetes type II into remission. It was called the Diabetes Remission Clinical Trial (Direct) and involved people with diabetes type II following a special supervised low-calorie diet.
Now an Irish association of health experts, the Irish Society for Clinical Nutrition and Metabolism (IrSPEN), has its own good news. They have found that remission is achievable by 50% of people living with type II diabetes if they can lose 15% of their body weight. This information is relevant to people with type II diabetes who have a BMI over 30. If you are 16 stone, for example, with a BMI of over 30, it would mean losing two and a half stone (34 lbs). Treatment in the trials included specialist diets, specialist medication and surgery.
“There is no single silver bullet,” says Professor Carel le Roux from IrSPEN, “but rather that multiple approaches have to be used to optimally treat patients who have complications of obesity.”
Not every patient responds equally, he says, but reversal of complications can be achieved. “In two out of 10 people with complications from diabetes, those complications can be reversed with the use of specialist diets, three in 10 with the use of medication and another five in 10 with the use of surgical treatments,” says Professor le Roux.
slash COST FROM €4,000 TO €500
It’s a “kill two birds with one stone” situation, with both the person and the taxpayer’s pocket benefiting, IrSPEN says. The person can have the joy of stopping or reducing the amount of medication they need, and this change will also mean that instead of their care costing the State €4,000 per annum it will only cost €500.
At present, the cost of treating all obesity-related diseases is approximately €1.16bn per annum. In Ireland, one in four adults are now obese and one in four children are overweight or obese, with 2,000 deaths attributable to obesity each year.
WHAT SPECIALIST DIET INVOLVES
Ah, yes, but losing weight is not that easy. What does the specialist diet involve?
The supervised Direct low-calorie diet of 800 calories a day for eight to 20 weeks, for example, involves having four soups or shakes each day. These have all the essential vitamins and minerals. The initial period of eight to 20 weeks is followed by a long-term programme of weight-loss maintenance, under supervision.
For others in the trials who had serious difficulty achieving and sustaining the required weight-loss, however, surgery was suggested.
In remission
This is what happened in Letterkenny woman, Laura Sloan’s case. She has experienced remission of diabetes since having bariatric surgery. Speaking to Irish Country Living, she talks about how serious her condition was prior to the treatment in July last year.
“I had gestational diabetes on my first pregnancy 16 years ago, and it happened again on my second pregnancy and never went away after,” she says. “By the time I had my third child, I was on insulin six times a day. Because of situational difficulties, I was comfort eating during those years also, so my weight spiraled. I managed to lose it in 2012, but it all piled back on again,” says Laura.
Because nothing was working for Laura on the weight-loss front, her doctors suggested that she try surgery. “I went for it straight away, because I was thinking: ‘How long is it going to be before I lose my eyesight or a limb because of diabetes?’”
Laura was also finding the injection and tablet routine tedious – and all the hospital appointments. For her surgery wasn’t a drastic move. “It was a case of ‘Tell me where and when’, because nothing was controlling my diabetes,” she says.
Since last summer, Laura has not needed insulin injections or medication, as her diabetes has gone into remission. “I have to take a multi-vitamin and a calcium tablet – that’s it,” she says.
She explains that she was on a pre-op 800 calories a day diet in order to reduce the size of the liver before surgery. Afterwards she went through stages of liquid diet, mash and finally onto solids.
“The majority of weight-loss happens in those first months and it just keeps gradually going down and down. It then levels out when you find out what you can eat a day and how full you get. It’s a learning curve. My BMI is now on the normal scale for the first time in I don’t know how long. I’m actually sharing my 14 year old’s wardrobe at the moment because I don’t have a thing to fit me.”
She is delighted that her diabetes is now in remission. “I’m glad that I am going to be able to watch my children grow up without that black cloud of diabetes type II hanging over me. I worry about them too, but it’s been an eye-opener for us all. We’re more active now, we’re into healthy eating and are more adventurous with cooking. Your taste buds change and you can’t eat the stuff you did before. No more fish-and-chip suppers for me. I’m just not interested in that anymore.”
Reversing pre-diabetes
John Kane is from Dublin and has been involved in clinical trials to lose weight.
“I have lost 15% of my body weight as part of a specialist multidisciplinary service, and my pre-diabetes has now been reversed,” he says. “My sleep apnea is also much better because of the weight loss, and I feel 10 years younger.”
SURGEON SAYS IT’S A POSITIVE MESSAGE
John Conneely is a consultant metabolic surgeon at the Mater hospital in Dublin. “European Obesity Day on 19 May last was an ideal opportunity to remind people that type II diabetes can go into remission if the person is able to lose 15% of their body weight (if BMI over 30),” he says.
“This is a really positive message to people living with the condition to consider all of the options available to support them with this goal – including diet, exercise, medication and surgery. A lifetime dependency on medication can be removed.”CL
HOW THE BREAKTHROUGH HAPPENED
Diabetes UK announced a breakthrough on 6 November 2017, in using a low-calorie diet to put type II diabetes into remission in some people.
This study, called the Diabetes Remission Clinical Trial (Direct) had reached the end of its first year of trial and 45.6% of those who followed a low-calorie diet, under the supervision of a GP, had put their type II diabetes into remission.
Weight-loss was a key factor. In all, 86% of people who lost more than 15kg on the programme were in remission after a year, as were 57% of people who lost 10kg to 15kg, and 34% who lost five to 10kg. The low-calorie diet of 800 calories a day mentioned previously was used followed by supervised maintenance. Remission is defined as blood glucose (or blood sugar) levels returning to the normal range.
However, Diabetes UK and Ireland warn: “This doesn’t mean diabetes has gone for good. It’s really important for people in remission to get regular healthcare checks, so any complications can be monitored and any signs of type II diabetes coming back can be caught early.”
warning: DON’T GO IT ALONE
Following a low-calorie diet to put type II diabetes into remission is not a quick-fix, it is very challenging and it is not recommended to try this alone, Diabetes Ireland also says.
Anyone with type II diabetes considering losing weight in this way needs to discuss it with their GP and dietitian to get tailored advice and support.
If a person is taking medications that has a risk of low blood glucose levels (hypos), sulphonylureas or insulin, they will need to consult with their GP, as their medications will need to be adjusted as the weight-loss continues.
It would also be necessary to monitor the blood glucose levels more closely at home and keep a watchful eye for hypos.
Participants of the study needed the ongoing support and advice of experts to gradually re-introduce normal food into their diet and get support to help them maintain their weight-loss in the long term.
DIABETES IRELAND comment
Diabetes Ireland’s UK counterpart, Diabetes UK, has committed extra funding to investigate the possibility of delivering this type of treatment through the public health service.
“In light of this, we would urge the HSE to consider investing in planning a similar intervention to fund and resource GP care teams to deliver such a programme, and improve the quality of life for thousands of Irish people with type II diabetes,” Diabetes Ireland said.
Diabetes in numbers
• According to the WHO, 65% of the diabetes burden, 23% of the heart disease burden and between 7% and 41% of certain cancer burdens are attributable to overweight and obesity.• Savings are expected after three to five years of these new treatments being offered, IrSPEN believes.• If you are living with type II diabetes and obesity, it is a good time to re-engage with your medical team to discuss ways that
you might achieve 15% weight loss through diet, exercise, medical or surgical treatment.FOR MORE INFORMATION
Information available on www.europeanobesityday.eu
To find out more about the weight-loss diet, visit http://bit.ly/2fiDdy5.
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