For decades, doctors, medical organizations, and health bodies did not recognize diabetes as something reversible. It is surprising as they have always known that diabetes is a lifestyle disorder. In fact, medical books still do not use terms like “diabetes reversal”, as many experts believe that one can only manage diabetes but not reverse it or get rid of it. Thus, doctors just prescribe the pill and recommend taking those pills for the rest of their life. Even worse, people also find it comfortable to take pills daily instead of making any significant weight loss efforts. As a result, people are unlikely to stick to lifestyle prescriptions. It is all, even though even losing a few kgs over a period of a year or two may help considerably. However, studies suggest that more aggressive weight loss programs can help significantly reverse diabetes or reduce dependence on medications.
Here is a word of caution, when we talk about diabetes reversal, we are talking about type 2 diabetes, which affects 90% of people living with diabetes. However, lifestyle intervention has less benefit in type 1 diabetes as it is an autoimmune disease.
Fortunately, things are now changing for good. Doctors and medical experts finally accept that diabetes reversal without medications is a real thing. Nonetheless, many challenges remain as, despite the proof that diabetes is reversible, very few doctors are helping patients reverse diabetes.
It means that people should make efforts and take the initiative. After all, a patient needs to play an active role in reversing diabetes and other chronic disorders.
Is there any evidence that diabetes is reversible?
Astonishingly, doctors have known for a long that diabetes reversal is possible. Yet, they have been hesitant to accept that. Even more, what is interesting to note is that there is very strong clinical evidence. Some of the early evidence came from the middle of the 20th century. Perhaps the most robust evidence regarding the association between weight loss and diabetes reversal comes from findings that weight loss surgery can reverse diabetes in 60-80% of the cases. That is unbelievable. Almost 80% of those living with diabetes can start living without medications through specific interventions. One of the reasons why doctors neglected these findings is that these diabetes remissions happened due to weight loss surgery. For decades, doctors kept saying that weight loss helps but cannot reverse diabetes. But now things have changed. Studies show that even weight loss without surgery can reverse diabetes or lead to its prolonged remission.
One of the most extensive studies to date has been The DiRECT trial. It is a trial that changed all the early assumptions. This study in 149 people living with diabetes continued for one year. These were individuals diagnosed with diabetes in the last six years. All of them were given an 800-900 kcal per day diet. This resulted in significant weight loss. The study found diabetes remission through weight loss in whooping 46% of the cases in just 12 months. In addition, they all started living without medications. Not only that, but the rest of the participants could also significantly reduce their dosage of various medicines. What is impressive about this study published in the journal The Lancet is that it showed that almost all those who lost 15 kg or more in a year could reverse diabetes. If diabetes reversal efforts are started earlier, they might help in more than 90% of the cases. It also shows that weight loss is the most effective way to reverse diabetes in obese individuals. It is more effective than all the medications. However, researchers warn that these benefits can only be sustained if weight loss is maintained. If a person regains the lost weight, diabetes also re-emerges. It appears that diabetes occurs due to many reasons and not just due to high carb intake. Obesity causes high inflammation and accumulation of fats in the pancreas and liver, which significantly worsens insulin resistance.
Weight loss as a primary way to treat diabetes
It is beyond doubt that obese individuals should consider weight loss as the leading way to reverse diabetes. However, the medical community is still slow to adopt these interventions or make recommendations. It is because doctors are not adequately trained in weight-loss interventions. They have more significant expertise in diagnosing the condition and prescribing the drug. Fortunately, things are changing slowly. Many leading healthcare organizations are now saying that it is time to prescribe a low-calorie diet and weight loss as the primary way to reverse diabetes. Just take an example, in 2018, NHS finally decided to start recommending 800 calorie diet for weight loss and diabetes remission to those living with obesity and diabetes.
However, things are still not so good. Despite the strong clinical data that leaves little doubt that weight loss is the single most effective way of reversing diabetes, very few people can expect their doctor to start diabetes treatment with a weight loss program. So, it means that the primary responsibility for weight loss lies on the shoulders of patients living with diabetes. But, first, they need to be very clear that they can reverse their diabetes and start living without medications through weight loss. These studies show that many of these individuals may even reverse their hypertension, prevent heart disease, and may experience many other health benefits.
Starting with weight loss for diabetes reversal
So, once a person has decided to start a weight loss program and reverse diabetes, the primary question is how to get started?
Get started with a very low-calorie diet
Perhaps the best way to get started is with a very low-calorie diet or an 800-1200 calorie diet. One should not be worried about the complexity of such a diet. However, it is worth understanding that such a diet is recommended for just about three months. For three months, the person primarily switches to a liquid diet, thus consuming weight loss smoothies, weight loss shakes, soups, and other foods. Then, after 12 weeks, other foods are reintroduced gradually, generally throughout a couple of weeks. And after that person can continue with a moderately low-calorie diet like an 1800-2000 calorie diet for a long. However, one may also continue with a very low-calorie diet for a long time. Still, doctors do not recommend that due to worries about nutritional deficiencies. It is worth understanding that the human body generally stores the most vital nutrients for about three months. It means that three months of a highly restrictive diet can be safe yet highly beneficial.
One can expect to lose significant weight in three months, like 10 kg or more. Of course, those grossly overweight would generally lose more weight. Such severe dietary restrictions may have some issues like headaches, changes in sleep patterns, constipation, etc. Nonetheless, studies show that such a diet is relatively safe when practiced for three months and under medical supervision.
Who would benefit most from an 800-1000 calorie weight loss diet?
Generally, grossly overweight individuals are more likely to benefit from such a diet. However, when using this diet for diabetes reversal, those diagnosed recently will benefit more than those living with long-established diabetes. If a person is living with diabetes for a much longer period, like ten years or more, such weight loss measures would still help, but the chances of complete diabetes reversal are low. This is because, in those living with diabetes for longer intervals, most of the insulin-producing beta cells in the pancreas have been lost. It is still unclear if some beta cells can regenerate through prolonged lifestyle interventions.
Who should avoid 800 calorie diet?
Such a highly restrictive diet should be cautioned in those living with diabetes for more than 10 years or in older adults. Additionally, such a diet may not help much if a person is already dependent on insulin. Further, this diet form is not for those living with type 1 diabetes. Moreover, those living with type 1 diabetes are less likely to be obese.
Start exercising – start with aerobic training
What happens when you jog, run, or dance at a moderately fast pace? Blood starts rushing throughout the body, and the heart starts beating fast. Skeletal muscles begin burning calories. Aerobic exercise can be an excellent way to lose weight, reduce insulin resistance, and boost cardiorespiratory health. Generally, if you are training for weight loss, exercise in the morning. It is because, in the morning, blood glucose is naturally low. When a person prepares in the morning, the body is forced to burn fats to produce energy. However, one would benefit from exercising just any time of the day. Additionally, pay particular attention to exercise intensity. It should be moderate-intensity exercise. For example, if a person is 40 years of age, one should exercise fast enough to ensure that heart rate climbs to about 110-120 beats per minute. When it comes to duration, one can start even with 15 minutes a day and aim for a minimum of 30 minutes. However, 60 minutes a day of exercise may be even more beneficial. Exercise also boosts basal metabolic rate, and it means that person continues to burn more calories even while resting.
Start resistance training
Although people understand the importance of aerobic workouts, running, walking, jogging, many do not understand the importance of weight training or resistance training. Some even think that training with weights may be inadequate for diabetes. However, when training for weight loss, one should understand that muscles burn calories and not fat cells. As you increase your muscle mass, you are more likely to have lower body weight and lower body fat content. Since many individuals do not focus on increasing muscle mass, they experience benefits from aerobic training for the first few months, and then they stop making progress. Thus, if you are among those and find it difficult to understand the cause for lack of progress, the reason could be low muscle mass. Aerobic exercises and weight training work best when combined. However, they are not mutually exclusive.
Think about stress management and training your mind
Train your body, but do not neglect your brain. There is now strong evidence that obese individuals also have other issues. They are more likely to be addicted to food or have a higher prevalence of stress, anxiety, and depression. Many of these individuals seek relief in food, and thus they tend to become obese. Thus, practicing yoga or mindfulness could be a way of reducing stress. It may also help manage anxiety and depression. Of course, this would ultimately lead to attitudes toward the food. But, of course, deep-rooted habits cannot be changed overnight. Thus, one can only expect benefits from yoga and mindfulness after three to six months of continual practice.
Final thoughts
Diabetes is a chronic metabolic disorder that is often associated with obesity. It means that weight loss can help reverse or control diabetes. New studies show that weight loss may even help people start living without medications. Even if it does not entirely reverse diabetes, weight loss can significantly help lower the dosage of various anti-diabetic drugs. However, it is worth understanding that when managing chronic ailments, much responsibility for managing the condition lies on the patients. Doctors are there to help provide advice. However, patients should carry out lifestyle changes. When making lifestyle changes, learning about the disease and managing it is vital. Hence, anyone living with diabetes and overweight should seriously think about starting a weight loss program. In many such cases, obesity is the underlying cause of the disease. So, in such cases, medications may help. Still, they cannot reverse the condition until or unless the underlying cause of the disease is managed.
コメント