Can a Very Low Calorie Diet (VLCD) Reverse Type 2 Diabetes?
Yes, research has shown that very low-calorie diets can reverse Type 2 diabetes. Evidence from both the Diabetes UK funded DiRECT trial as well as The NHS Type 2 Diabetes Path to Remission programme demonstrate that a 12-week structured very low calorie diet plan followed by healthy lifestyle support can lead to significant weight loss, resulting in the potential remission of Type 2 diabetes.
The Role of Weight Loss in Managing Type 2 Diabetes
Put simply, weight loss is crucial in managing T2D as it can markedly improve insulin sensitivity and reduce blood sugar levels. Multiple studies underscore the importance of weight loss as an effective intervention because it has been clearly shown to impact diabetes in the following way:
- Reduces Insulin Resistance: Losing even 5-10% of body weight can significantly improve the body’s ability to use insulin effectively.
- Lowers Blood Sugar Levels: Sustained weight loss can lead to better glycaemic control.
- Reduces the Need for Medication: Many individuals who achieve significant weight loss can reduce or eliminate their dependency on diabetes medication.
Is there specific type of weight loss plan that is most effective?
Yes, research has clearly shown that a formula-based very low calorie diet (VLCD) has been shown to play a significant role in reversing T2D. Evidence from studies such as the DiRECT trial and NHS remission programmes clearly demonstrates that structured, medically supervised VLCDs can lead to significant weight loss, resulting in the potential remission of Type 2 diabetes.
Evidence from the DiRECT Study
The DiRECT study found that participants who followed a structured VLCD programme achieved significant weight loss, which led nearly half of them to achieve diabetes remission at one year. The remission was sustained in 36% of participants after two years with these findings underscoring that weight loss through a VLCD is an effective, non-invasive method to manage and potentially reverse Type 2 diabetes.
VLCDs and Their Superior Role in Reversing T2D:
A very low-calorie diet (VLCD), which is a formula diet and typically involves consuming fewer than 800 calories per day, primarily through meal replacements Foodpacks including soups, shakes, and bars provides a nutritionally balanced eating plan, but with a very limited energy intake. This encourages the body to use stored fat for energy, thus resulting in weight, particularly fat, loss. Recent data from NHS investigations into the use of these formula food plan for diabetes remission showed that at 12 weeks, individual experiences with the plans were largely positive with VLCDs having provided control with eating behaviours which contributed to weight loss and improved glycaemic control. Also, at 12 months, many participants reported improvements in psychosocial and physical functioning, and continued use of MRP and TDR products as a weight maintenance mechanism was evident.
Key Studies Supporting the Efficacy of VLCDs
- DiRECT Study: This landmark study explored whether weight loss through a VLCD could induce diabetes remission. Over 300 participants took part, and the results were published in The Lancet Diabetes & Endocrinology. The findings showed that significant weight loss led to diabetes remission in almost half of the participants. For more information, visit the DiRECT Clinical Trial.
- DROPLET Trial: Led by the University of Oxford, the DROPLET trial evaluated VLCDs in achieving weight loss among individuals with obesity, demonstrating superior weight loss outcomes. This weight loss directly contributes to better diabetes management, highlighting the effectiveness of VLCDs in clinical settings.
- PREVIEW Project: A large-scale, multinational study aimed at preventing Type 2 diabetes through lifestyle interventions. One of the study’s key components was an 8-week VLCD phase, which yielded significant weight loss and improved insulin sensitivity. More detailed results can be found by searching academic databases for the “PREVIEW study Type 2 diabetes.”
- NHS Type 2 Diabetes Path to Remission Programme: Inspired by the DiRECT study’s success, the NHS developed this programme to help patients achieve remission through a structured VLCD plan. This programme involves a 12-week total diet replacement phase followed by food reintroduction and long-term maintenance. Early results from the NHS programme show that nearly one-third of participants achieved remission. Read more about it on the NHS Type 2 Diabetes Path to Remission Programme.
- Churuangusak et al. Study: This study, available on PubMed, found that total diet replacement (TDR) plans were more effective than other dietary interventions for weight loss and diabetes management.
Summary of Findings
The collective data from these studies solidify the role of formula based VLCDs in reversing Type 2 diabetes. The structured approach and medically supervised settings ensure safety and efficacy, highlighting the potential for broader implementation in diabetes management strategies.
Longer-Term Management of the Condition
Achieving diabetes remission is a significant milestone, but maintaining it requires continued effort. Long-term management includes:
- Gradual Transition from VLCDs: After the initial VLCD phase, it’s important to reintroduce balanced meals while maintaining a reduced calorie intake to prevent weight regain.
- Ongoing Support: Structure support during and after the VLCD phase is crucial to help individuals adapt to and maintain their new healthier, sustainable eating habits.
- Physical Activity: Incorporating regular exercise helps maintain a healthy weight and improves overall metabolic health.
The Role of Continued Medical Monitoring
Ongoing medical check-ups are essential for tracking blood sugar levels, weight maintenance, and overall health to prevent relapse.
The Importance of Food Choices and Mindfulness to Reduce the Risk of Relapse
Maintaining Type 2 diabetes remission involves more than just dietary choices. It requires a mindful approach to eating and lifestyle:
- Balanced Meal Planning: Structured meal plans that include VLCD meal replacement shakes, soups, and bars can help maintain weight loss and prevent relapse.
- Healthy Snacking and Hydration: Avoiding high-sugar, high-fat and energy dense foods while staying hydrated contributes to balanced blood glucose levels. Minimise snacking and where possible and make healthier high fibre, high protein options to help reduce excessive calorie intake.
- Exercise and Lifestyle Adjustments: Regular physical activity not only helps with weight maintenance, but it also enhances insulin sensitivity and promotes greater overall health and wellbeing.
Mindful Eating Practices
Mindful eating involves being aware of food choices and portion sizes, and ensuring that you are responding to genuine physical hunger instead of an emotional need to eat. Planning meals and snacks in advance can help maintain good habits and support long-term health.
FAQs to Address Common User Questions
Can Type 2 Diabetes Be Permanently Reversed?
Whilst remission is possible, “permanent” reversal depends on long-term weight management and lifestyle changes. We can’t say that someone won’t ever develop the condition again because this will rely at the very least on them continuing to adhere to a healthy balanced diet, keeping their body weight down at their new lower lever, preventing any significant regain, and exercising regularly too. There will be many who can almost certainly achieve this, however there are studies ongoing to determine the longer term impacts of a having followed VLCD on those with T2D in terms of weight management and recurrence of disease.
How Long Should a VLCD Be Followed?
In the past VLCDs have been recommended for shorter-term use, typically up to 12 weeks. That said, many individuals for whom a VLCD is suitable have followed a plan for longer than this, and for up to several months if that’s what they have needed to do to lose the weight they wish to lose, with no adverse effects.
What Are the Risks Associated with VLCDs?
VLCDs are a safe and effective method for helping those with T2D lose weight and there are no greater risks using this type of method for weight loss in patients with T2D than there is with any other dietary method. Speaking with a healthcare professional in advance to adjust any medications being taken is necessary prior to starting the diet, but other than this, if there are no other contra-indications and your HCP is happy, you can start a VLCD whenever you are ready.
