I don't think that it's common knowledge among patients with Type 2 diabetes that the disease can be reversed by dieting (see: The Changing Face and Diagnostic Challenge of Diabetes; "Curing" Diabetes with Bariatric Surgery; No Nation Has Lowered Its Obesity Rate in 33 Years). Some physicians may prematurely direct their patients to drug treatment of the disease rather than toward the more challenging path of dieting (see: Patients Diagnosed with Type 2 Diabetes Started on Drug Therapy Prematurely; Can You Reverse Type 2 Diabetes?; Few Good Treatment Options for Pre-Diabetes and Metabolic Syndrome). A recent article made reference to a study indicating that Type 2 diabetes can be reversed with a liquid diet and that the disease reversal may persist (see: Hope for Reversing Type 2 Diabetes). Below is an excerpt from the article:
...[N]ew research raises the tantalizing possibility that drastic changes in diet may reverse... [Type 2 diabetes] in some people. Recently, a small clinical trial in England studied the effects of a strict liquid diet on 30 people who had lived with Type 2 diabetes for up to 23 years. Nearly half of those studied had a remission that lasted six months after the diet was over....Studies have also shown that obese individuals who have bariatric surgery frequently see the condition vanish even before they lose very much weight. But the new study... proved the reversal after diet can persist for at least half a year as long as patients keep weight off, and can occur in people who have had the disease for many years. The researchers followed the participants after they had completed an eight-week low-calorie-milkshake diet and returned to normal eating. Six months later, those who had gone into remission immediately after the diet were still diabetes-free. Though most of those who reversed the disease had had it for less than four years, some had been diabetic for more than eight years.....In the United States, some 8.9 percent of adults 20 and older have been found to have diabetes, and health officials estimate that another 3.5 percent have undiagnosed diabetes....Excess fat in the liver can spill into the pancreas, inhibiting insulin secretion and the liver’s response to insulin, resulting in insulin resistance and diabetes. Going on a very-low-calorie diet may allow the body to use up fat from the liver, causing fat levels to drop in the pancreas as well. That “wakes up” the insulin-producing cells in the pancreas, normalizing blood glucose levels. While some previous studies have shown that blood sugars can normalize after significant weight loss, endocrinologists said they were impressed by the persistence of the lower blood sugar levels for months after the diet.
We need a campaign to educate patients that their Type 2 diabetes can be reversed through dieting and exercise. For me, such an option would be the obvious choice. I can't conceive that taking drugs and worrying about my blood glucose level would be perceived as the "easy" way. However, I have blogged extensively about the obesity epidemic in the U.S, (see: The Obesity Epidemic as an Economic Driver for the Clinical Labs; Projected Future Costs of Obesity to "Crush" U.S. and U.K. Healthcare Systems; What's Behind the Obesity Epidemic: Food Too Accessible and Inexpensive). I thus understand that serious dieting may not be an appealing option for the majority of patients.
Readers may may a question what constituted a liquid diet in the study referenced above. Here are the details: The participants in the....trial, who ranged from overweight to extremely obese, were told to stop their diabetes medications and start a 600- to 700-calorie-a-day diet, consisting of three diet milkshakes a day at mealtimes and half a pound of non starchy vegetables a day. I suspect that for many of the subjects, such a diet was not too onerous, at least for a relatively short period. The trick, as always, is to keep the weight off after leaving the liquid diet. Here are some more details about liquid dieting (see: What Are Liquid Diets?):
...[T]he results [of a liquid diet] may not last. When you drastically cut calories, your metabolism slows to save energy. Unless you change your eating habits, you're likely to regain the weight you lost after you go off the liquid diet. Some liquid diets work better over the long term than others. Diets that include both solid food and liquids can help overweight people control the number of calories they eat and help keep the weight off for several years.