The routine treatments provided through our health system
address the symptoms of type 2 diabetes, but in some cases the
condition can be beaten into remission.
In these cases, success means losing weight, and keeping it
Type 2 diabetes is a progressive condition that can lead to
heart disease, nerve damage, kidney disease and blindness.
Some type 2 cases are driven not so much by a person's weight,
but by genetic factors. In these cases, the strategy required to
address type 2 and to minimise its impact and the trend to
complications is less straightforward.
But for the majority of people, turning type 2 around means that
with sustained weight loss it may be possible to reduce or
eliminate the need to take insulin or to throw your tablets
That would be a huge boost to people's health and savings
personally, as well as to our national health budget, because about
5 per cent of people have type 2 diabetes.
For most people with type 2, getting your blood glucose levels
back into the healthy range, and keeping them there, means you need
to lose about 10 per cent of your body weight, and keep it off.
analysis paper in the BMJ, (British Medical Journal), Dr Mike
Lean, professor of nutrition at Glasgow University, argues that
giving medication to reduce blood glucose (the main treatment for
type 2 diabetes) only addresses the symptoms.
"Virtually everyone with type 2 diabetes is at least 12 to 19kg
above their ideal weight," Dr Lean said.
"One of the great tragedies is that we've known this for about
100 years and all the treatments have ever done is reduce the blood
sugar. This is the consequence, but what drives it is the
Dr Lean says the easiest indicator of someone at risk of type 2
diabetes is a fat tummy. A man with a waist over 91cm or a woman
with a waist over 80cm could both be on the path to the
Another paper in Frontiers in Endocrinology describes a program
of high-intensity exercise as a way of preventing type 2 diabetes
developing in people with risk factors. But once it's developed:
"You can't run off diabetes," said Dr Lean.
He believes evidence suggests most people need to lose more than
12kg. Studies show woeful remission rates (0.14% of 120,000
US patients who were followed up for seven years).
Dr Lean is more optimistic, as his team is involved in a program
Counterweight Plus, which a pilot study showed led to a third
of people losing more than 12kg.
The program involves drinking formula shakes with a total of 820
calories for six to eight weeks, before reintroducing food that
includes a lot less fat, and ideally no alcohol.
The program is being further evaluated. Dr Lean says he is not
pushing his own solution. People should ask their GPs or health
practitioners for advice about any evidence-based weight-loss
The rewards of weight loss are high. A remission of type 2
diabetes (as long as you don't regain weight) means not only no
insulin or tablets for diabetes and a lower risk of complications,
but often the reversal of high blood pressure, too.