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Cited by 418Diabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and LipoproteinsBariatric Surgery and Outcomes

Very low-calorie diet and 6 months of weight stability in type 2 diabetes: pathophysiological changes in responders and nonresponders

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Steven, Sarah, Hollingsworth, Kieren G., Al-Mrabeh, Ahmad, Avery, Leah, Aribisala, Benjamin, Caslake, Muriel, Taylor, Roy·2016·Diabetes Care
DOI 10.2337/dc15-1942
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Abstract

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is generally regarded as an irreversible chronic condition. Because a very low-calorie diet (VLCD) can bring about acute return to normal glucose control in some people with T2DM, this study tested the potential durability of this normalization. The underlying mechanisms were defined. RESEARCH DESIGN AND METHODS: People with a T2DM duration of 0.5-23 years (n = 30) followed a VLCD for 8 weeks. All oral agents or insulins were stopped at baseline. Following a stepped return to isocaloric diet, a structured, individualized program of weight maintenance was provided. Glucose control, insulin sensitivity, insulin secretion, and hepatic and pancreas fat content were quantified at baseline, after return to isocaloric diet, and after 6 months to permit the primary comparison of change between post-weight loss and 6 months in responders. Responders were defined as achieving fasting blood glucose <7 mmol/L after return to isocaloric diet. RESULTS: Weight fell (98.0 ± 2.6 to 83.8 ± 2.4 kg) and remained stable over 6 months (84.7 ± 2.5 kg). Twelve of 30 participants achieved fasting plasma glucose <7 mmol/L after return to isocaloric diet (responders), and 13 of 30 after 6 months. Responders had a shorter duration of diabetes and a higher initial fasting plasma insulin level. HbA1c fell from 7.1 ± 0.3 to 5.8 ± 0.2% (55 ± 4 to 40 ± 2 mmol/mol) in responders (P < 0.001) and from 8.4 ± 0.3 to 8.0 ± 0.5% (68 ± 3 to 64 ± 5 mmol/mol) in nonresponders, remaining constant at 6 months (5.9 ± 0.2 and 7.8 ± 0.3% [41 ± 2 and 62 ± 3 mmol/mol], respectively). The responders were characterized by return of first-phase insulin response. CONCLUSIONS: A robust and sustainable weight loss program achieved continuing remission of diabetes for at least 6 months in the 40% who responded to a VLCD by achieving fasting plasma glucose of <7 mmol/L. T2DM is a potentially reversible condition.

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Authors
Steven, S., Hollingsworth, K. G., Al-Mrabeh, A., Avery, L., Aribisala, B., Caslake, M., & Taylor, R.
Affiliations
  • Newcastle University (GB)
  • Lagos State University (NG)
  • University of Glasgow (GB)
Corresponding author
Taylor, Roy
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2016-03-21
Volume
39
Issue
5
Pages
808-815
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc15-1942
OpenAlex
W2309974746
Cited by
418
References
41
Citations by year
2026: 20 · 2025: 29 · 2024: 37 · 2023: 35 · 2022: 47 · 2021: 51 · 2020: 47 · 2019: 53 · 2018: 36 · 2017: 43 · 2016: 18 · 2015: 1 · 2012: 1
FWCI
50.26
Type
journal article
Language
en
Update notices
correction (2018-06-01)
Open access
Licence
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • Teesside University Research Portal (Teesside University) (submittedVersion, other-oa)
  • Newcastle University ePrints (Newcastle Univesity) (cc-by-nc-nd)
Funders
  • National Institute of Health Research Newcastle Biomedical Research Center Grant
  • Novo Nordisk UK Research Foundation Research Fellowship
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
type 2 diabetes, very low calorie diet, weight loss, weight maintenance, diabetes remission, fasting blood glucose, insulin sensitivity, first-phase insulin response, insulin secretion, hepatic fat content, pancreatic fat content, diabetes duration, HbA1c
MeSH terms
Body Weight Maintenance, Adult, Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, Diet, Reducing, Fasting, Female, Humans, Insulin, Longitudinal Studies, Male, Middle Aged, Treatment Outcome, Caloric Restriction

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