Nearly half of participants who followed an intermittent calorie-restricted diet for three months achieved diabetes remission and no longer needed to take diabetes medication, according to a small new study by Chinese researchers.
Equally noteworthy, these individuals maintained their remission and were able to remain drug-free at the 1-year time point. Journal of Clinical Endocrinology and Metabolism.
The study shows that type 2 diabetes is not necessarily a permanent, lifelong disease, said co-author Dongbo Liu, PhD, a researcher at Hunan Agricultural University in Changsha, China. If you change your diet and exercise habits to lose weight, you can get diabetes into remission,” he says.
Intermittent fasting may mean restricting calories and eating only at certain times of the day
Intermittent fasting (IF) refers to a meal schedule that alternates periods of fasting (fasting) and eating. There are various plans, such as a calorie restriction plan for a specific time of the day or a specific day of the week. This type of diet is becoming a popular way to lose weight and has been shown to help people reduce their risk of heart disease and diabetes, so researchers have found a very specific type of diet. I decided to look at the impact of the IF diet on people who already have diabetes.
However, in this study, participants in the intervention group did not fast completely or limit meal times. Instead, they intermittently restricted calories and followed a specific diet.
5 days of calorie restriction, 10 days of normal diet
Investigators recruited 72 participants aged 38 to 72 who had had type 2 diabetes for 1 to 11 years and were using diabetes medications or insulin injections to manage their condition. did. Two-thirds were male, with body mass index (BMI) ranging from his 19.1 to 30.4.
According to the Centers for Disease Control and Prevention, a healthy BMI of 18 to 24.9 is considered overweight, 25 to 29.9, and over 30 is obese.
Researchers randomly placed participants into one of two groups. One group ate a modified intermittent fasting diet called the Chinese Medicine Nutrition Therapy (CMNT) diet. The other group had no restrictions on what they ate.
Participants followed 15-day cycles of the CMNT diet (5 days of modified fasting followed by 10 days of normal eating) for a total of 6 times during the 3-month trial.
On the modified fasting days, the subjects ate food prepared by scientists and containing ingredients such as wheat, barley, rice, rye, and oats. At 46% fat and 8% protein, this came to a total of 840 calories. That’s about a third of his recommended daily calorie intake for the average U.S. male.
Unlike some IF diets, participants were allowed to eat prescribed foods at regular intervals for breakfast, lunch, and dinner.
Almost half went into remission of diabetes
After three months, about 86% (31 of 36) of the participants in the intervention group, including those who were taking hypoglycemic drugs and insulin, reported the amount of diabetes medication they were taking. was reduced.
Of that group, approximately 55% or 17 of the participants went into remission (defined as A1C levels <6.5%) and discontinued antidiabetic drugs. After that, he maintained that level for at least a year, Dr. Liu says.
“These findings are very remarkable. More than 40% of the diet group went into remission, stopped the medication with the dietary intervention alone, and the results lasted at least a year,” said Josh Thaler. , MD, PhD says. He works as an endocrinologist and associate professor of medicine at his UW Medical and Diabetes Institute in Seattle. Dr. Thaler was not involved in the study.
Let me be clear: remission is not a cure. “There is no cure for diabetes,” he says. It has the effect of significantly reducing the incidence of diabetes, but we still call it remission.
This study has some limitations
While the findings are impressive, Thaler says there are a few things to keep in mind when evaluating research. First, the study was small. “They screened many patients, but only 36 of them were in the intervention arm in the end,” Thaler says.
In addition, it could be argued that even if everyone had diabetes, it might not be representative of all people with type 2 diabetes on average. “Most people who participated in the study had mild or moderate diabetes at the start of the study. On average, their A1C was already fairly close to target (due to their medication). Their diabetes was fairly well controlled, with only about 17-20% using insulin, and the weight range of the participants was lower than that typically seen in T2D patients.” he says.
Some who experienced remission had had diabetes for more than 6 years
This study overturns the conventional view that only people with diabetes for less than six years can achieve remission. “Of the participants in this study who achieved diabetes remission, 65% of them had diabetes duration between his 6 and 11 years,” Liu said.
In general, it’s true that people with diabetes for a long time may have a harder time experiencing remission, Thaler agrees. Because of this, you tend to be on more medications, perhaps insulin, and you may develop complications by then, so it can be more difficult to control at that point.
Participants in this study lost nearly 10% of their body weight in just three months
Can these results be replicated in the real world? That’s questionable, Thaler says, given how much weight the subjects lost.
The group that ate the CMNT diet averaged about 148 to 135 pounds and maintained their weight one year later. “That’s almost 10% of their body weight. That’s pretty dramatic, and it’s amazing what he can achieve in just five out of 15 days of cutting calories in three months,” he says. says Mr.
“We have a lot of patients who have tried various types of intermittent fasting, but even successful patients have not seen this level of weight loss and this fast.”
Even good medicine can’t reduce your BMI by 10% in three months, says Thaler. That’s why the medical community gets excited when a drug is shown to help him achieve 5 to 8 percent weight loss, he notes.
Studies with the most intensive interventions were considered successful if they lost weight in the range of 5–7%, and these people often reported having regained some of their weight by 1 year. he says.
“These patients were very adaptable and remained adherent for a year. Results like this are rare,” says Thaler. Study participants maintained their weight loss and were able to cut back on medication, he says. “This is true for almost any weight-loss intervention for diabetes. When a person loses weight, the diabetes usually improves, and when the weight is put back on, the diabetes either worsens or recurs,” he says. .