'Try diets before pills for diabetes': Patients with type 2 condition should get option to reverse it by losing weight before being given medication, experts say
Doctors must give people with type 2 diabetes the option to reverse it by losing weight before they are prescribed pills, experts said.
A panel of obesity experts and dietitians published a review of 90 scientific papers on people who have overcome type 2 through diet.
They point to evidence from a low-calorie diet of soups and shakes, which is being trialled by the NHS, that led to remission in 46 per cent of people.
They warn type 2, which is caused by obesity, should no longer be treated as unpreventable.
Dr Duane Mellor, co-author of the review published in the Journal of Human Nutrition and Dietetics, said: 'Lifestyle treatment is the best option and should be the first choice people are offered.'
Doctors must give people with type 2 diabetes the option to reverse it by losing weight before they are prescribed pills, experts said (stock photo)
Dr Adrian Brown, lead author of the scientific review from University College London, said: 'There is now a growing body of research that shows losing significant weight, 10 to 15kg (1.6 to 2.4 stones), either through weight loss surgery or dietary approaches, can bring about type 2 diabetes remission.'
Dr David Unwin, a GP in Southport, Merseyside, who also contributed to the review, said: 'As a doctor, I didn't see a single case of medication-free remission in people with type 2 diabetes for 25 years, which I now realise was my fault.
'I was prescribing drugs much too quickly but since I started looking at a low-carbohydrate diet, I have seen more than 100 patients achieve remission.
'People just need to realise that starchy foods like bread, cereals and potatoes digest down into very large amounts of sugar, and make the changes needed.'
The review says the typical amount of weight most people lose, of around 11 pounds (5kg) is unlikely to achieve remission from type 2 diabetes.
The key is to try to achieve a similar effect to gastric bypass surgery - after which most people no longer have type 2 diabetes.
These people achieve remission, often within 48 hours, because less food takes the conventional route through their digestive system, which may change hormone signals, so their liver tops up blood sugar less, and their pancreas controls it better.
A drastic diet also reduces the food in someone's system, so could 'reset' their metabolism to beat diabetes in the same way.
Meal replacement soups and shakes probably work so well because they help people lose 15kg (two stones and five pounds) or more, according to the experts.
Diets seem to work best in men, under-50s and people on low amounts of medication who have been diagnosed with type 2 diabetes in the past six years.
There is not enough evidence to see how intermittent fasting, like the 5:2 diet, works for type 2 diabetes remission, but trendy 'keto' diets seem to have an effect - although no more than cutting carbs in general.
Remission was defined as a return to a normal blood sugar level for at least six months.
Type 2 diabetes can lead to complications like heart disease, blindness and amputation, and it costs the NHS around £10 billion a year.
The review concludes that doctors should always talk to people about remission, and that soups and shakes may be more appealing when they are free of charge on the NHS.