Until recently, type 2 diabetes was primarily controlled by controlling risk factors such as hypertension, cholesterol, and blood sugar (glucose), but was usually controlled by prescribing medication. However, this approach does not address the underlying causes of type 2 diabetes, such as insulin hormone problems that prevent effective control of blood sugar levels. Although taking medication can control blood sugar levels, it does not reveal the biological cause behind type 2 diabetes.
More and more studies show that losing weight, either by surgery or on a diet, may help address some of the underlying causes of type 2 diabetes. It does this by helping the body control blood sugar levels. This is important because controlling blood glucose levels by improving insulin production and action is key to relieving type 2 diabetes.
Most of this series of studies to date have considered using meal replacement shakes to help people with type 2 diabetes. Therefore, this approach may be prescribed by a doctor. But more recently, researchers have begun investigating other diets, such as the low-carb diet, to achieve remission. Research in this area is still in its infancy, but research results show that low-carb diets are promising so far.
To better understand which diet is best for achieving type 2 diabetes remission, a recent review examined more than 90 papers explaining the effects of different diets on type 2 diabetes. .. Higher quality studies tended to focus on meal replacement shakes used in clinical trials, but other approaches (such as low-carb diets) have been shown to work well.
According to our review, dietary alternatives helped about 1 in 3 people achieve remission, and low-carbohydrate diets helped about 1 in 5 people achieve remission. People who lost weight using both of these diets were able to maintain remission for up to two years if they maintained weight loss.
A low-calorie and Mediterranean diet could also help people achieve remission, but at a much lower rate. Only about 5% of people on a low-calorie diet maintained remission after one year, while only 15% of people on a Mediterranean diet maintained remission after one year.
Definition of remission
One of the big challenges I faced when writing a review was to define what “relief” was. Knowing how to define it was important to understanding which diet was most effective in helping people achieve remission.
The reason this was difficult is that different groups of experts and research studies have different definitions. Most people define remission as a drop in blood sugar that is below the range for diagnosing diabetes, although some definitions say that this should be done without the use of drugs. , Some are not. By another definition, you need to lose weight (especially central fat) to achieve remission.
It was necessary to lose some definition of gastric fat in remission. (Africa Studio / Shutterstock)Another challenge we faced when defining remission was that there were reports suggesting that a low-carb diet can normalize blood glucose levels without losing weight. This is because when you eat carbohydrates, they are broken down into sugar and your blood sugar level rises. A low-carb diet means lower blood sugar levels in the bloodstream, leading to better blood sugar control.
Therefore, we initially defined remission using the definitions used in each study. Next, we compared the number of people whose blood glucose levels normalized without drugs for at least 6 months. This is mostly considered to be true remission.
Relaxation v remission
Low-carb diets help people achieve remission, but there are concerns that blood sugar levels can rise again as soon as more carbs are eaten. For this reason, the review suggests that type 2 diabetes is still present and should probably be called “diabetes relief” rather than this remission, but the adverse effects are well managed. increase. We believe that remission can only be achieved if fat is lost from around the organs. This allows you to make insulin and use it effectively again.
However, carbohydrates are also a major source of energy in our diet, so eating less of them consumes less calories and usually results in weight loss. Therefore, if someone can maintain a low-carb diet for a long period of time, it may not only reduce the risk of blood sugar and diabetic complications, but also achieve remission.
Anyway, the evidence examined in our review reveals that there are many ways in which a person can significantly improve blood sugar levels through diet, which can often lead to remission. The important thing we have found with each type of diet is that you need to lose at least 10-15 kg of weight to achieve remission.
However, while weight loss appears to be the best predictor of success, it assumes a loss of fat from the pancreas and liver. Since type 2 diabetes can occur in underweight in different ethnic groups who may lose less weight, future studies will show how these diets work in different ethnic groups. It is important to compare.
Not everyone can achieve remission, but young (under 50) men with type 2 diabetes and who are losing weight are more likely to succeed. This may be because these people can reverse the cause of diabetes and better restore the pancreatic insulin-producing capacity and the liver’s insulin-using capacity. However, this does not mean that others will not succeed if they improve their diet and lifestyle and lose weight.
Lowering blood sugar levels, whether or not a person achieves remission, is important in managing the adverse effects of type 2 diabetes and reducing the risk of complications. But when it comes to choosing a diet, the most important thing is to choose the one that suits you – the ones you are likely to stick to in the long run.
Duane Mellor, Evidence-Based Medicine and Nutrition Leads, Aston University School of Medicine, Adrian Brown, UCL Research Fellow & Lecture
This article has been republished from Conversation under a Creative Commons license. Please read the original article.
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