Controlled diet may reverse diabetes

Is reversal of diabetes possible with calorie modification? A new study conducted abroad, which is being followed with case-controlled studies in India, promises this possibility. In this experimental treatment module, also referred to as Very Low Calorie Diet (VLCD), patients with early onset diabetes are not given medication but are put on a controlled diet -reducing daily calorie intake by less than half of normal diet -for rapid weight loss.

“The VLCD diet aims to achieve benefits of a bariatric surgery without operation. We have tried it on some patients but failed to achieve desired results since no one could follow up with diet chart for long enough,” Dr Anoop Misra, chairman of Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology . Dr Sujeet Jha, who heads the endocrinology division at Max hospital Saket, said they have also tried it on some patients.

“A 48-year-old patient who was diagnosed with early onset diabetes came to us recently with a specific request that he didn’t want to take lifelong medications to control the disease. We have put him on VLCD diet. It will be too early to discuss results,” he said.

While a normal diet contains 1600 to 1800 calories, diabetologists say VLCD attempts to bring down calorie intake to 600 to 800 calories. Research on its effectiveness, which has been published in a recent issue of medical journal Diabetes Care, states that VLCD for a significant duration helps remove excess fat from the pancreas. “This allows beta cells to return to producing normal levels of insulin in response to glucose,” it states.

Dr Jha said following VLCD is a tough task. “Calorie reduction is needed but at the same time we have to ensure that the patient gets enough protein, vitamin and minerals.Regular tests to check kidney and liver function is also essential,” he added.

In the study carried out by researchers from Newcastle University , University of Glasgow, and Lagos University , 30 diabetics were put on VLCD for eight weeks. It consisted of diet shakes and non-starchy vegetables.Out of 30 people, 12 had normal insulin levels after eight weeks and similar results were seen even after six months.

“It is too early to predict the utility of the VLCD for diabetes reversal in all patients. We need larger studies and more scientific data to make such claims,” Dr Jha said.

The research could best be described as a ray of hope for millions suffering from the disease who have to be on lifelong medication to maintain blood sugar levels. In obese patients with diabetes, surgery is shown some benefits, he added.