Gerry Gajadharsingh writes:
“Some patients think private healthcare is “expensive” as the NHS provides everything for “free” so it’s good to know that they are putting a price on the rollout of the so-called “soup and shake diet” for managing type two diabetes. It’s going to cost approximately £1,100 to the taxpayer for each patient.
The findings are the latest result from the Diabetes Remission Clinical Trial (DiRECT), funded by Diabetes UK, which found that patients with type 2 diabetes can go into remission if they follow an intensive weight-loss plan.
The DiREC trial recruited 298 patients with type 2 diabetes through GP surgeries. Initial ground-breaking findings, published in 2017, showed that 46 per cent of those on the diet for three to five months were in remission one year later, with 36 per cent in remission after two years.
The updated results show that 23 per cent of those in remission after two years were still free of symptoms five years later. This group who were in remission had an average weight loss of about 9kg (1st 6lb) at the five-year point.
The thing about weight loss is that it is the metabolic changes that are a consequence of dietary change leading to better glucose management with weight loss as a positive side effect. The soup and shake diet consists of one soup a day and two shakes a day and that is all that the patient is meant to eat. This is extremely challenging for many patients, and I wonder whether it’s actually necessary. What we have found with Metabolic Balance is that a major impact comes from eating just three meals a day and not snacking in between meals. It is the snacking in between meals that pushes up insulin and leads to insulin resistance. As long as the three main meals of the day contain good quality dietary protein and fat and low glycaemic load carbohydrates, mostly in the form of vegetables. This also produces excellent results in regard to metabolic change and weight reduction for many people.
Intensive weight loss programs such as the soup and shake diet, which is providing only 800 cal a day can be challenging for many reasons, for example, one of the known side-effects of intensive weight loss programs can be the emergence of cholecystitis. Many people, especially peri and postmenopausal women will have coexisting gallstones, and many people don’t know they have them. Losing weight too fast and sometimes allowed his gallstones to move, and if they get stuck in the bile duct can cause inflammation and infection and quite severe symptoms often for the need for an operation to remove the gallbladder.
When I was an undergraduate, we were taught to respect several medical conditions, including type two diabetes, which many people thought was completely irreversible at the time. My experience with helping patients through a Metabolic Balance individualised nutritional program, especially with type two diabetes, has definitely had very positive effects at normalising HbA1c, the three-month glucose marker tested by a blood test, which is generally used as the gold standard for monitoring patient’s glucose levels, allowing patients to not need their diabetic medications.
So, it’s good to know that the medical world now agree that type two diabetes is reversible with significant dietary change. I would also agree that many dietary programs that is short-term of three months or less can often help with weight management, however, dietary change needs to be long-term otherwise as soon as patients go back to their normal eating patterns, they will fall off the wagon, and in this case their type two diabetes will come back again. I note that the research below suggests a 23% success rate at five-year follow-up, which doesn’t sound hi to me. However, I’m sure the NHS will treat it as a numbers game and 23% of 4 million people who have type 2 diabetes, who are in remission from type two diabetes after five years will be seen as a success.”
The Times
Eleanor Hayward
Going on a radical “soup and shake” diet can permanently reverse type 2 diabetes, a landmark British trial has revealed.
Patients who stuck to an 800-calorie-a-day diet for three months, then kept the weight off, were free from symptoms five years later and no longer needed medication.
The “remarkable” findings confirm that type 2 diabetes is reversible, proving for the first time that the benefits of weight loss continue for the long term. It gives hope to more than four million Britons who have type 2 diabetes that they can put the condition into remission, improve life expectancy and avoid potentially deadly complications.
Tens of thousands of patients with type 2 diabetes will now be prescribed the “soup and shake” diet on the NHS, costing £1,100 per patient, under a “revolutionary” nationwide plan.
The findings are the latest result from the Diabetes Remission Clinical Trial (DiRECT), funded by Diabetes UK, which found that patients with type 2 diabetes can go into remission if they follow an intensive weight-loss plan. Remission means blood sugar is under control and patients no longer need to take medications such as metformin tablets or insulin injections to manage their glucose levels.
Professor Roy Taylor, of Newcastle University, who led the study, said the new five-year follow-up result showed that “the benefits of weight loss could be permanent and lifelong”. He added: “This result is wildly important. We had shown that weight loss is highly effective, but the question had always been — how long will that benefit last?
“This new finding shows that type 2 diabetes is reversible in the long term. Losing weight removes the drivers of type 2 diabetes and means the body can achieve normal glucose levels. Those factors will be lifelong.
Patients have been able to escape from their diabetes. If they keep the weight off, they will remain healthy. I avoid saying ‘cure’ because it has not gone away completely. This is remission because if people put on the weight they have lost, the diabetes will come back.”
Five years in remission is a milestone in medical terms, as the chance of diseases such as cancer returning falls dramatically after the five-year mark.
The DiREC trial recruited 298 patients with type 2 diabetes through GP surgeries. Initial ground-breaking findings, published in 2017, showed that 46 per cent of those on the diet for three to five months were in remission one year later, with 36 per cent in remission after two years.
The updated results show that 23 per cent of those in remission after two years were still free of symptoms five years later. This group who were in remission had an average weight loss of about 9kg (1st 6lb) at the five-year point.
If people put a significant amount of weight back on over the five-year period, the diabetes symptoms returned. However, they were still less likely to develop complications requiring hospital admission than a control group who did not follow the three-month “soup and shakes” diet.
One of the trial participants, Kieran Ball, has been in remission for type 2 diabetes for eight years. He lost 22kg during the initial low-calorie diet and has since maintained this weight loss.
Ball, 47, from Morpeth, Northumberland, said: “Those few months on the low-calorie diet were hard, but I’d do it again, no question. It’s amazing that what I went through all those years ago is still benefiting me today. I’m still in remission and not on any diabetes medication — I can’t quite believe how long it’s been.”
The NHS said the trial’s “fantastic” results meant that it would expand the scheme across England in the next 12 months, after a test run showed that patients lost 12kg in three months, on average. The meal plan consists of two shakes and one soup a day, containing all necessary nutrients.
Professor Jonathan Valabhji, the national clinical director for diabetes and obesity at NHS England, said: “The NHS is already making the best use of this research for patients through our low-calorie diet programme, which has seen fantastic early results, and we plan to expand the scheme nationwide.
“With participants losing over 2st in three months on average and maintaining that weight loss at six months, rolling out low-calorie diets on the NHS may help many more people to turn the tide on type 2 diabetes.”
Ten per cent of the NHS budget — about £10 billion a year — is spent on diabetes, which can cause heart disease, stroke, nerve damage, blindness and kidney failure.
Dr Elizabeth Robertson, the director of research at Diabetes UK, said: “For those who put type 2 diabetes into remission, it can be life-changing, offering a better chance of a healthier future. For those that aren’t able to go into remission, losing weight can still lead to major health benefits, including improved blood-sugar levels and reduced risk of serious diabetes complications.”
Over the past decade, our ideas about type 2 diabetes have been transformed (Eleanor Hayward writes).
Thanks to research led by Roy Taylor at Newcastle University, it is no longer seen as a lifelong disease, but one that can be reversed.
Diabetes is when there is too much glucose in the blood. Most people with type 2 do not produce enough insulin, the hormone that controls blood sugar levels. Obesity leads to excess fat in the pancreas, the organ that produces insulin, stopping it from working properly and triggering type 2.
We now know that losing weight rapidly is enough to get the pancreas working again, so patients do not need medication.
The discovery has huge implications for the NHS. UK cases of diabetes doubled in the past 15 years, and more than five million people are estimated to have the condition, 90 per cent type 2.
Ten per cent of the NHS budget is spent on treating diabetes and its complications. Rolling out low-calorie diets is a vital part of a new strategy, that could save thousands of lives.
Patients will be prescribed meal replacement packs of milkshakes and soups for three months and supported through a year-long programme. The average patient loses two stone while on the soup and shakes diet.
Costing just £1,100 a patient, this is a cheap way to tackle obesity.