Diabetes Self-Management Blog

You probably saw the news. Scientists and journalists are saying a two-month starvation diet has “cured” or “reversed” Type 2 diabetes in 11 people. Actually, there were some benefits, but nothing close to a cure. What can we actually learn from this study?

Well, the first thing we learn is that many people are totally ignorant when it comes to the temporary nature of weight-loss benefits. The second thing is that journalists will hype scientific results far beyond what the studies actually show.

In this study, 11 people with Type 2, and a similar number of controls, were placed on a 600-calorie-a-day diet. They ate only liquid diet drinks with non-starchy vegetables like broccoli. Their insulin sensitivity and the fat content in their livers and pancreas were monitored, as well as their blood sugar levels.

The study was done at Newcastle University in the United Kingdom and sponsored by the charity Diabetes UK. To quote their press release:

After just one week…[subjects' fasting] blood glucose levels had returned to normal… A special MRI scan…revealed that the fat levels in the pancreas had returned from an elevated level (8%) to a normal (6%) level. In step with this, the pancreas regained the normal ability to make insulin and as a result, blood glucose after meals steadily improved.

The starvation diet lasted two months, after which, “The volunteers were returned to eating normally but had received advice on portion size and healthy eating.” Three months later, 7 of the 11 people with diabetes still had normal blood glucose levels. One man was quoted as saying he still did not need any diabetes medicines after 18 months.

This research was presented at the American Diabetes Association’s scientific sessions in San Diego and published in the journal Diabetologia.

The theory behind the starvation treatment is that fat stored in the pancreas interferes with insulin production. Studies in mice and humans have shown that fat in the pancreas can damage beta cell function and the cells themselves. Lead researcher Roy Taylor, MD, said that “the very low-calorie diet reduced the amount of fat in the pancreas and liver, which allowed insulin production and function to return to normal.”

How does he know that, though? Reducing pancreatic fat could have caused the improvement, but maybe the beta cells just had less to do and were able to keep up. Or maybe lower glucose levels allowed the beta cells to function better. On 600 calories a day, you would need very little insulin.

And even after returning to a reasonably healthy diet, fat and muscle cells will be gobbling glucose and fat to refill what they’ve lost. This process can go on for weeks or months, so blood glucose levels will stay low until the fat deposits are back where they started.

Dr. Taylor said he got the weight loss idea from looking at the results of bariatric surgeries. As we’ve reported before, some of these people virtually wake up from surgery with their diabetes in remission. Why? Dr. Taylor thought it might be that rapid weight loss was de-fatting the pancreas and liver, improving insulin function. He wanted to replicate the crash weight loss that bariatric surgery patients experience to see if nonsurgical dieters could get the same results.

This reasoning seems illogical, because even after bariatric surgery, it takes a little bit of time to see significant weight loss. But the diabetes remissions often occur right away. A more likely explanation is that reconfiguring the intestines enables normal insulin function, as we discussed here. The rapid weight loss might contribute, but it’s not the whole story, or even most of it, in my opinion.

What’s the bottom line? It looks like excess pancreatic fat is bad for you, and possibly getting rid of it would be good for your diabetes. But we know that weight regain is the norm. Dr. Taylor himself said the real challenge is figuring how to keep the pancreatic fat off.

So the best thing one can say about the starvation treatment is that it could jumpstart the recovery process by helping people regain better insulin function temporarily. Then if they self-manage extremely well, they might be ahead of where they would have been if they hadn’t starved. But the more likely outcome will be that most of the starvers will regain the weight they lost and more, because that’s how bodies respond to dieting. And some of that fat will probably end up in the pancreas.

After three months of being “cured,” four of the eleven subjects have relapsed. In another six months, probably another four will have relapsed. Hopefully, one or two will stay diabetes free, but I wouldn’t bet on it.

Maybe this study was worth a try. I just wish scientists like Taylor wouldn’t self-promote and health journalists wouldn’t sensationalize. I mean, this is a study of 11 people for three months, and they’re announcing a cure? Read all such announcements with serious skepticism.

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Comments
  1. There is no doubt the a hypocaloric diet makes blood glucose better nearly immediately. While I was loosing weight on a 1400 calorie/day diet my BG was only slightly too high but after loosing 85 lb I had to stop loosing weight and resume an isocaloric diet. The BG jumped up immediately before any fat was regained and I had to fight with the doctors (they are very insulin resistant) to go on insulin.

    So from my narrow viewpoint I think David is reading this correctly. The very low calorie diet which BTW may be very low carb also since it is very low everything does immediately relieve the pancreas and does permit more normal blood sugars.

    A cure hardly.

    Posted by calgarydiabetic |
  2. I see a lot of comments concerning type 2 diabetes and failure in weight loss attempts. Here is my free advice for what it is worth:

    I exercise pretty regularly walking between 15 to 30 miles per week and was still not losing any significant weight. I still had that pot belly but firm everywhere else (Classic Syndrome X) The solution lies in your lifetime eating habits. The South Beach Diet is such an eating plan. There is a restriction of carbs for the first 2 weeks. But it is definitely not Atkins which can put a diabetic’s already compromised kidneys at greater risk.

    If you can replace most (not all) rice, potatoes, pasta, keep your bread to 1 or 2 slices a day with BEANS as your source of starch you will see results.

    It is happening to me. I eat a tremendous amount of nuts as a snack and after the first 2 weeks eat a moderate amount of fruit (particularly low glycemic ones like blackberries blueberries, oranges, apples and mosty summer fruits (but not too much watermellon). I also try to eat a lot of vegetable and salads with regular, not “diet” dressings. Protein sources are your own choice.

    Weight Watchers is another choice but I find it too difficult to weigh foods or measure portions. Also, with diabetics, it may contain too many carbs.

    SO do some research on South Beach and also look at the many recipies developed for the plan. It is working for me. I have lost my craving, for the most part, of the bad carbs.

    Posted by GARY COHEN |
  3. Huh? Why is this being reported as news? Back in the late 1980’s very low calorie diets were a sort of a fad for treating type 2 diabetes (but then it was called Type II). Here is the abstract of an old journal article I found easily by Googling “diabetes very low vcalorie diet”:
    http://diabetes.diabetesjournals.org/content/35/2/155.short

    Notice all the articles at the bottom of the page that reference this one!

    So why is this considered news? Don’t the people 50 and older remember this?

    Posted by Beth |
  4. Sure, starvation cures Type 2! I really doubt there were any Type 2’s in the concentration camps! Of course, they were in very poor condition, and dying regularly, but not of Type 2 diabetes!

    What perturbed me about this study is that it was very short-term, and had a high drop-out rate. In other words, it was not practical for the average person.

    And while it is true that in primitive cultures where no one gets much above starvation rations, there is no Type 2 diabetes, but we just can’t live that way in our modern society.

    I would like to see more research into all the various things that go wrong in order to produce obesity, and efforts made to correct them, rather than simply blame and shame the fat person.

    Posted by Natalie Sera |
  5. I ahve been type 2 for about four years now. My sugar went to 8000 and I was put on intensive insulin therapy in the hospital. When I was released I walked 1200 miles in 6 months, ate a strict diet of protein and veggies, and was taken off all diabetic medication (4 shots a day to nothing at all) in 6 months.

    I have continued to eat a lower carb diet (even that has been relaxed a bit over the years, but my number are still less than 100 to 110 three and a half years later.

    I have put weight back on however my numbers have stayed normal.

    I do not consider myself cured, I consider myself as living with a condition that if not monitored will be right back to where it was. However if I keep monitoriing myself and do not increase my weight any further, (I would like to take off weight again), I should be able to stay off medication for a good time to come. But I am not cured.

    Posted by Bob |
  6. Reply to Gary Cohen - oranges have a very high glycemic index )according to the charts I’ve seen), and watermelon has a low index (much to my surprise).

    Posted by tbdent |
  7. Societies in which people eat mostly unprocessed
    vegetables, fruits, grains, some nuts & seeds &
    10% or less animal & dairy products tend to have
    very low incidence of type 2 diabetes, heart disease & other chronic diseases, which are common
    in people who eat the standard American diet. I recently saw a PBS TV presentation on nutrition by
    Dr. Joel Fuhrman (Dr.Oz refers patients to him for
    help with nutrition problems). I was impressed by
    his concept of the importance of nutrient density
    per calorie & the use of the Aggregate Nutrient
    Density Index for rating various categories of food.I read his 2 book set “Eat for Health” & watched several of his videos on You Tube - example - “Nutrient density per calorie” & “Disease proof your child”. He explains micronutrient/phytochemical -rich leafy green & multicolored vegetables & suggests eating home made vegetable stews, salads,seeds & nuts, blended smoothies & sorbets. I also suggest book “The China Study” & http://www.dr.mcdougall.com.

    Posted by apple japonica |
  8. This all shrinks back to some key factors:

    a) you have old hunter gatheror gene set not the new fangled 35% of population who can eat the super carbonydrates and high fructose sugars.

    b) you need to be on the mediterranean diet and get off the dense carbohydrates.

    c) you needs tons of exercise that folks on this old gene set had to expend getting sufficient calories.

    Starving is not issue when you have leaky liver in make sugar mode all the time dumping in extra glucose. I had horrible time getting weight down even on 1200 to 1500 diet until I got my liver nailed with the metformin drug taken so as to boot liver back to fasting mode.

    I really wish folks would knock off the simplistic one answer solves all.

    Posted by jim snell |
  9. On Sept. 21, 2011 I went in for my regular check up & blood test. Later that day I got a call telling me I am diabetic and my fasting glucose was 172 and A1c was 8.1. As soon as I got off the phone I googled “Diabetes Cure” and found the UK study. I thought I can do that… so from then on, for the next 8 weeks I starved myself. The first week I lost 10 pounds and my fasting glucose went down to 77! After the 8 weeks I did an A1c and it went down to 5.4 and I am getting normal daily glucose numbers that I was checking before I ate, an hour after I ate and 3 hours after I ate. I lost a total of 36 pounds in 8 weeks and did it all on my own. I have done a few “tests” where I eat high surgar foods such as orange juice with English muffin and Strawberry Jam. After an hour my glucose jumped to 144, but another hour it came down to 98 and another hour after that was back in the 70’s! I keep a paper and pen in my pocket at all times and write down the exact time I eat and exactly what and how much I eat. If anyone would like to see my records and notes, email me and I will email you a copy. My email address is [removed]

    Posted by Mike Ellingson |
  10. The above poster is correct about “leaking livers”. This diet may still work if the liver has fatty deposits that can be removed through diet and exercise, however if a liver is damaged through means other than fat deposits, ie. hepatitis, NAFLD, HSV-2, etc. a diet wont cut it. Damaged livers leak sugar into the blood. Thats why “dawn phenomenon” occurs. There is evidence to show that the liver is self-repairing, but depending on the degree of damage or the progression of such viral liver attacks it may be forseeable that regardless of what a diabetic eats they may progress even from oral medications such as metformin to insulin. I have a very difficult time explaining to people that firstly, not everyone with type 2 diabetes is over weight and lastly, that root of a diabetics’ problems can be the liver and not the pancreas.

    Posted by Margaret |
  11. I am fed up with your people every time there is hope to get rid of this terrible desease you smash it down. Sufferers want rid of diabetes and they want it now. Every desease has a cure if we did bit know it. Ther seems to be almost glee anytime something doesn’t work. No folks we ahve got you and eventually you will die from it. Don’t fight it don’t try and cure you don’t have a chance. Thanks for nothing. This is a big industry maybe it doesn’t want a cure. Fed up.

    Posted by Michael |
  12. Michael, after you try the starvation cure and see what happens for a couple of years, please get back to us. In the meantime, if you’re looking for a cure, check out my blog entry “Can Type 2 Be Reversed?”

    Posted by David Spero RN |
  13. The frustration expressed is valid.

    Presently the science and technology used to sort out a multi hormone complex chemical plant is in the dark ages with nobody agreeing on anything aince they do not have technology to capture the detail and provide a clear detailed picture medical science can agree on. Hence the jumble of competing theories and ideas. All partially right and all partially wrong.

    Jumping on Taylor is in appropriate. AT least he is applying some 21st century gear to work on and surface some newer information.

    The numbers of cases and rate of increase all point out WE ARE NOT SOLVING this issue and in fact running on spot or worse.

    provide a list of latest technology that has advanced our knowledge:

    a) single shot - instant in time lab tests for chemical analysis
    b) fingerprick caveman machines
    c) cgms with one week ( 2 for some)sensors delayed interstitial response with assorted gronks.
    d) mri cmenical spectography but limited and very expensive.

    and?

    We do not yet have a portable analysis pack that can watch and analyze data from the body for 24/7 for 3 days so we get detailed package of what is actually going wrong/right through multiple digestion cycles/sleep/exercise etc.

    In fact the starvation diet is really a misnomer as these diets are attempting to haul back the claorie input more consistent with minimum needs and getting glucose saturation of the skeletal muscles stopped - hauled back and getting body running again.( which while there is MRI spectography showing the temporay glucose storage in skeletal muscles - not one dam donkey agrees such things exist or its correct impact in causing insulin resistance as body downgrades the insulin receptor sites of the muscles to reduce glucose transfer when no more room to store any more.)

    The problem is that diet, energy burn, liver operation and hormonal issues all factor into the puzzle and it may not be possible to pick 2 factors and work those and be successful. If they are the only offending factors one can have more straightforward success working those.

    In my case my liver completely swamped my 1200 calorie diet and 2 miles walking.

    I never starved on my 1200 calorie diet.

    The hooting and hollering is serving no one at this time as well as the heat seeking missle targeting a single search for simplistic overall cure approaches while ignoring the complexity and operation of the human chemical plant due to lack of sufficient diagnostic gear to facilitate better debugging.

    Posted by jim snell |
  14. my hba1c is 8.2 fbs 230 weight 58 kg june
    with glimped+met fbs 90 august2012
    witout medicine fbs 70 september

    Posted by harvinder |
  15. There is a large percentage of the population for whom eating 600 calories a day will indeed reverse diabetes. The drug companies that would prefer to sell you ways to alleviate your symptoms will do everything to make sure you don’t believe that. But we (fat Americans) have created an entire industry for type II diabetes. Poor countries don’t have this disease. And for all you religious zealots out there, this IS THE DEFINITION OF GLUTTONY. When you stop eating more than you need to survive, this will become self evident.

    Imagine that - you eat less, spend less money on food, there is no longer a need for expensive prescriptions.

    I am 130 pounds 5′8″ and I’m starting to try intermittent fasting. We didn’t get here over the last few hundred thousands of years shopping at the grocery store. Your brain makes new neurological connections when you are hungry because it thinks you have to get creative to find food. So on top of everything else you’ll be smarter, too.

    Seriously people get off the couch and stop eating too much.

    Posted by ladye |
  16. Well I am recently diagnosed diabetic and was given 6 weeks to change my lifestyle. I was never an over eater and my body weight was normal.
    But I was asked to loose weight. I ate only minimum of starch prior to diagnosis and the dietician suggested I eat a snack of grapes or a cup of milk which induced G spikes in my blood.
    I bought a BLG self check meter and monitored my postprandial levels to determine what I can eat to maintain normal Fasting levels. I found out I can’t eat any starch, nothing at all and even vegetables supposedly low GI. I have to narrow my food intake to fish, leafy veg, nuts coconuts and a glass of vine. Now the fasting BGL are normal but I doubt that I can go back and eat whatever I was eating prior to the diagnosis. If I am cured from this strict diet I should be go back to what my normal diet was right. But I have noticed even slightest intake of veges increase my BGL. So, the study proves strict diet can bring down the FBG levels, but not a cure. Cure to me is I should be able to go back to my normal diet. So what I am doing is eating as little as possible to accommodate the insulin I have and I have to stick to the diet for the rest of my life. Not just that eventually I might not have enough insulin at all to overcome the problem, and might need to take medication.
    It is apparent that some articles just indicate diabetes can be cured. If diabetes can be cured then the pancreas must go back to normal just like a common cold or any other disease, and secrete normal levels of insulin, muscle glucose uptake should be normal and we will be living happily ever after. Unfortunately, we need to exercise to get rid of glucose in the blood, or to facilitate uptake of glucose by muscles, eat only foods that has minimum GI value to accommodate insulin levels and eat a bit more good fats to increase Glucogen activity. However I am still looking for the cure that people are talking about so I can go back to my normal diet with no medication.

    Posted by Indira |
  17. Indira,

    It certainly sounds like some injected insulin would make your life easier. With your weight and your diet, if you had anywhere near enough insulin, you would not be having these spikes. If you can manage your numbers with the diet you are on, and if you can stay with it, that’s great. But if this is not something you can keep doing for life, ask your doctor to be checked for LADA, and consider insulin.

    Posted by David Spero RN |
  18. Indira raises some very good questions.

    In my view and experience, whne one goes on the tight diet 600 calories/1200 calories; I believe there is a mistaken view that this is a cure and one can go back on the ole diet afterwords. Nope.

    WHat one is doing from where I sit is to drop energy input to body to drop glucose overload and saturation and then very carefull increase diet but to ensure maintaining energy balance on the body. The old diet was loading in too much energy and now one has to run to keep energy balance and keep from backing in too much glucose that if one is not burning off by sufficient exercise/energy burn, the body ’s only recoarse is to store the glucose that leads to recreating the problem.

    The work CURE is inappropriatly used. Stopping the diabetes and rot yes. Eating as one used to and surviving it - do not think so.

    Even from Dr. Taylor’s work and even from bariatric surgery work at my local hospital - they start the patient at 600 calories and very carefully prevent the high calorie eat anything mentality or one loses all the benefits.

    Most clearly, once one has the body running again under proper numbers; energy balance MUST be followed with sufficient exercise energy burn.

    I heard from Dr. Taylor’s groups and people who did this diet approach had to maintain tight diet calorie input control, exercise and discipline or the bad numbers returned. That does not mean one stays at 600 calories but also means one does not jump to 2000 calories either.

    Posted by jim snell |
  19. The author of this article misrepresented the study to make it sound less impressive than it is. Agreed, it was a small sample - but why dismiss out of hand the evidence that a calorie-restricted diet can lead to huge improvements and - yes, in some cases - a cure of type 2 diabetes.
    Why not give it a try? Surely a healthier option than relying on medication!

    Posted by nona |
  20. I have also got rid of diabetes from last 2 years by extreme starvation for 2 months,weight loss of 20% of body weight and then maintaining low weight.
    My diabetes H1BC was 80 and now I am eating sweets and full diet and no diabetes.Thogh I go for a daily walk now for 2 kms.
    The fat on deposits on pancreas and liver help to get normal for a long term.
    The morning blood gulcose levels from 9-10 which should be under 6 are generally beteen 4.5-5.

    I think Dr. Taylor’s groups reseach was very worthwile and f and I also got rid of diabetes based on the this research.

    Though I also drinked lot of green juices while on extreme diet along with Yoga.

    Posted by Pranabh Jain |
  21. Thanks for sharing your story, Pranabh. It now seems that Dr. Taylor’s very low calorie approach works for some people. He told me that he has received many letters like yours.

    However, for many other people, like Calgary Diabetic who commented above, the benefit doesn’t last.

    I’ve come to think it’s worth a try, if you’re physically and mentally up to it.

    David

    Posted by David Spero RN |
  22. Missed point about starvation diets.

    The critical issue missed in all this is that starvation/reduced diets are critical and necessary initially to get excess glucose stored in body burn off and exhausted out. It is a rational step in the process of yanking a type 2 body that has been running over saturated/overloaded with glucose for long periods of time.

    My read is that is accomplished, calorie levels can be slowly and safely brought back up to weight maintenance levels.

    The constant niggling over simplistic simple step control approaches hides the science of the issues of getting a body whose glucose levels have been running excess and too high for too long.

    Been there, got it under control and it can take a horrendous effort of meds, diet, exercise and discipline to yank a body back in control.

    For those who only need an exercise increase, some simple diet/portion control to gently reduce numbers, I agree starvation diets do not make any sense or little sense.

    Posted by jim snell |

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