1 July 2011

GI Symbol News with Dr Alan Barclay

Dr Alan Barclay
A new cure for diabetes?
A new study in the Lancet has crunched the numbers and tells us that in just under 30 years, the number of adults with type 2 diabetes has more than doubled from 153 million in 1980 to 347 million in 2008 . Most due to increasing numbers of larger, older people. It’s thought that risk factors like obesity, lack of physical activity and poor diets account for the rest.

Not to worry. There’s a ‘cure’ shout the headlines a few days later when a new two-month ‘extreme diet’ that ‘offers a hope of a cure for type 2 diabetes’ was published in Diabetologia. Cure? Let’s take a look.

Eleven obese people with type 2 diabetes were put on a very low calorie diet (600 cal/2500 kJ a day). It consisted of three sachets of Optifast a day plus non-starchy vegetables (salad greens, onions, capsicum/peppers).


After eight weeks they lost an average of 15.3 kg/34 lbs (around 15% of their body weight) and their BGLs and triglyceride levels returned to normal, their pancreatic and liver fat levels decreased, and their livers became sensitive to the effects of insulin again. A big improvement – but what happened next?

Most of the stories neglected to mention that three months later, the weight came back: there was an average weight re-gain of 3.1 kg (7 lbs) when the participants were ‘provided with information about portion size and healthy eating’ and 3 out of the 11, or 27% of participants ‘had recurrence of diabetes’. No details on the ‘healthy eating’ advice was given.

A new cure? Not really. What the study shows is that if you go on a very low calorie diet your symptoms of type 2 diabetes will go into remission if you are obese (not everyone with type 2 diabetes is obese of course). However, remission is the key word. Because type 2 diabetes is a metabolic disease – it’s not something you catch – your symptoms will return if you slip back to your old lifestyle.

It's not possible to live your life on Optifast or similar products. So, the essential ingredient is what healthy eating plan should you follow after you have lost that initial 15% of your body weight to prevent weight re-gain and a return of diabetes symptoms – and that part of the study was sadly neglected…

Regular readers of GI News will recall that the Diogenes study we covered last year found that a moderately high protein, low GI diet was the best plan for longer-term weight loss maintenance. Interestingly, the first phase of this study also involved use of a very low calorie diet like Optifast. This successful combination (very low calorie diet followed by a moderately high protein, low GI diet) may help some people with type 2 diabetes put their diabetes in to remission and keep it that way for a much longer period of time.

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For more information about the GI Symbol Program
Dr Alan W Barclay, PhD
Chief Scientific Officer
Glycemic Index Foundation (Ltd)
Phone: +61 (0)2 9785 1037
Mob: +61 (0)416 111 046
Fax: +61 (0)2 9785 1037
Email: alan@gisymbol.com
Website: www.gisymbol.com


Christine Michael said...

Good post, thank you. I think what was also interesting about this study is that it was inspired by the remission of diabetes symptoms seen after weight loss surgery; the researchers wanted to know if extreme calorie reduction and rapid weight loss could achieve the same results without surgery. In this very small trial, it did seem to achieve that with 7 of 11 participants. So although it may give us valuable clues into how and why weight loss is so valuable in type 2 diabetes, it is not, as you say, anything like a cure. I've written more about this on www.diabeteschoices.org.uk if readers are interested.

Unknown said...

I'm doing the optifast program now and the program in the states is 100% medically supervised...you can not do it outside of a doctor's care. The training classess are actually an hour and a half for 20 weeks. The go over everything from nutrition, exercise and the thing that will help me keep my wait off...the diabetic food exchange chart!!! That thing will be an absoltue life saver! Marketing this as a cure is just silly....but I know gastric bypass is being marketed that way as well. This is an excellent way to get you out of the "danger zone" and give you the tools to make life changing food choices. Your palet is pretty clear from being on 800 calories for 14 weeks and then going to 1000 then 1200 (1500) for us dudes.