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T2 Diabetes remission success rate for Low Calorie diets?

pdmjoker

Well-Known Member
Messages
426
Type of diabetes
Prediabetes
Treatment type
Diet only
(I wasn't sure where best to post this)

I've seen success figures for Dr David Unwin reversing Type 2 Diabetes with Low Carb diets: nearly half his T2 patients are now in remission.

Has anyone seen any success figures quoted for T2 remission with Low Calorie diets?

Thanks in advance!
 
I would make sure that the term 'remission' has clear definitions in the sources, and whether they are comparable.
The definition can sometimes vary between studies, and certainly between people's interpretations of the studies and their own circumstances.

Apparently, by Roy Taylor's definition of 'remission' I have been in it for years.
But that means nothing to me, since my body wouldn't stay in remission if I ate moderate carbs for more than about a week. Been there, done that, the T shirt is rather old now.
 
I totally agree with you. I am now coded diabetes resolved but moderate carbs would also take me out of diabetes resolved in a week - or maybe even less than a week.
 
Last edited:
Dark Horse said:
Presentation from Professor Roy Taylor on the DIRECT (diabetes remission clinical trial):- https://www.directclinicaltrial.org.uk/Documents/AAA FINAL DiRECT 12m results for IDF 2017.pdf
Click to expand...
Thank you!

Slide 6 of the presentation shows Usual dietary advice remission success of 13% (2y RCT)

I gather Diabetes REmission Clinical Trial features:

roughly 830k cal per day meal replacement formula and 30 mins daily aerobic (PA) exercise for 12-20 weeks

Then

Stepped Food Reintroduction:
Add a ~400kcal meal every 2-3 weeks
Step-counters: gradually increase PA

and

Weight Loss Maintenance:
Food-based diet
50%E carbohydrate, 35% fat, 15% protein
Encourage up to 15,000 steps/day

Results: 46% remission at 1y, 36% remission at 2y

Naturally, they excluded people who couldn't safely do the exercising aspect.

@Brunneria By "remission" they mean no diabetes meds and HbA1c either normal or pre-diabetic.

It doesn't sound a pleasant eating regime at all, and arguably far worse than Low Carb. (This aspect of quality of life didn't seem to enter into their quality of life calculations.)
 
pdmjoker said:
Naturally, they excluded people who couldn't safely do the exercising aspect.
Click to expand...

And
Anyone taking insulin
Anyone diagnosed for longer than 6 years etc etc..
There was quite a long list of exclusions.. the very definition of "cherry picking" your subjects.
Haven't seen Prof Lean mention that often.

Meanwhile he and his team come out with stuff like this.


From here
https://www.directclinicaltrial.org.uk/Documents/Patient Info Website Feb 2018.pdf

Such a charmer eh?
 
pdmjoker said:
@Brunneria By "remission" they mean no diabetes meds and HbA1c either normal or pre-diabetic.
Click to expand...

Yes, but you then need to compare that definition of 'remission' with all the other definitions used by other people and other studies. Otherwise you are comparing apples and oranges.

A general consensus has been gradually emerging, but you still get some shockers, such as where someone claims they are in remission after 3 weeks on a green smoothie diet, or 6 weeks into their marathon training regime, while carb loading... that kind of thing.
 
@bulkbiker
Saying

(WARNING: Do NOT confuse this with a commercial website (….diabetes.co.uk) whose content may appear attractive, but which is often incorrect or misleading).
​
is quite an allegation. I wonder if he can cite examples?

I fell for that (was directed to Diabetes UK by HCP, but thought this site more helpful and informative) and it resulted in me reversing prediabetes through Low Carb.

I hadn't realised I had been deceived by this site until reading that warning.
 
I believe that DUK part funded the original ND work and may also be part funding DIRECT.

https://www.diabetes.org.uk/researc...ht/research-spotlight-low-calorie-liquid-diet
 
I wonder how many of us are grateful.that they were 'misled' by this site? Me for one!
 
Here is the current membership of SACN (now called SCAN) and their declared interests.
https://assets.publishing.service.g...ile/895292/SACN_Register_of_Interests_v23.pdf

Note that there are declared interests connected to Sainsburys, Nestle, General Mills and other food suppliers. There is one declared vegan, but I researched others and found evidence of vegetarian interests not declared in this doc. I see Susan Jebb is also chair of NICE which is one of the organizations this committee reports to.

Many are shown as officers in the Learned Society of Nutrition whatever that is, and there are some BNF members too. There is even an editor for Nature.

These are the people that make the decisions on Eatwell so they are important to understand their backgrounds.
 
830 calories for 12-20 weeks? Woah! That would nuke the metabolism and burn off lean mass, the very things we need to preserve.
 
LaoDan said:
830 calories for 12-20 weeks? Woah! That would nuke the metabolism and burn off lean mass, the very things we need to preserve.
Click to expand...
Yep. That's what happened to me years ago when this sort of diet was said to be dangerous. It was dangerous, it made me fatter long term. I can't understand why a very low cal diet has suddenly become acceptable to the mainstream. Oh wait, I expect it has something to do with ...money?
.
 
The diet is based on what I remember was called The Cambridge Plan which was indeed subject to serious backlash at the time. It is still going today, and supplies shakes to the DIRECT diet plan currently. Optifast shakes have a very similar formulation.
 
pdmjoker said:
It doesn't sound a pleasant eating regime at all, and arguably far worse than Low Carb. (This aspect of quality of life didn't seem to enter into their quality of life calculations.)
Click to expand...
Apparently, the Quality of Life measurement consists of:
mobility, self-care, usual activities, pain/discomfort, and anxiety/depression​
 
pdmjoker said:
I fell for that (was directed to Diabetes UK by HCP, but thought this site more helpful and informative) and it resulted in me reversing prediabetes through Low Carb.

I hadn't realised I had been deceived by this site until reading that warning.
Click to expand...
@JohnEGreen
If I had stuck with Diabetes UK and hadn't been "deceived" by this site, I expect now I would be clinically obese and T2 diabetic, plus feeling guilty since (obviously) the patient is always to blame if "Eat less, Move more" fails...
 
pdmjoker said:
@JohnEGreen
If I had stuck with Diabetes UK and hadn't been "deceived" by this site, I expect now I would be clinically obese and T2 diabetic, plus feeling guilty since (obviously) the patient is always to blame if "Eat less, Move more" fails...
Click to expand...

I know what I did was drastic and possibly dangerous but extreme circumstances sometimes require drastic action in my case:

MG = little or no exercise

Long term high dose of prednisolone = huge weight gain + diabetes

What I felt at the time was my only course of action to try and correct matters was:

Low carb + restricted calories = weight loss + lower blood sugars and unfortunately muscle loss low energy and disrupted metabolism.

But I had to accept the rough with the smooth.

I spent some time with Diabetes UK then serendipity brought me here with it's awful deceitful ways that saved my bacon.
 
The Direct study at least proved a principle that stripping away pancreatic and liver fat reversed insulin resistance and hence type 2 diabetes and that doing this early in diagnosis was less effective than later on but I'd agree that there are more pleasant ways such as low carb!
The 2nd stage of research looked at numbers who maintained remission and found that a declining percentage had remained in remission but that was still better than the control group. The study group had received dietary advice about how to maintain their weight loss.
Practices were randomly assigned (1.1) via a computer-generated list to an integrated structured weight management programme (intervention) or best-practice care by guidelines
At 24 months, 53/149 (35·6%) of those commencing the intervention and 5/149 (3·4%) in the control group (adjusted odds ratio 25·8, 95% CI 8·3,80·8; p<0·0001) had remission, and 11·4% (17/149 of intervention and 2·0% (3/149) of the control group (adjusted odds ratio 8·2 (2·2,30·0), p=0·002) had weight loss ≥15k
 
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