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Cited by 170Bariatric Surgery and OutcomesDiabetes Treatment and ManagementDiabetes Management and Research

Reversing Type 2 Diabetes: A Narrative Review of the Evidence

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Hallberg, Sarah J, Gershuni, Victoria M, Hazbun, Tamara L, Athinarayanan, Shaminie J·2019·Nutrients
DOI 10.3390/nu11040766PMC PMC6520897
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Abstract

Background: Type 2 diabetes (T2D) has long been identified as an incurable chronic disease based on traditional means of treatment. Research now exists that suggests reversal is possible through other means that have only recently been embraced in the guidelines. This narrative review examines the evidence for T2D reversal using each of the three methods, including advantages and limitations for each. Methods: A literature search was performed, and a total of 99 original articles containing information pertaining to diabetes reversal or remission were included. Results: Evidence exists that T2D reversal is achievable using bariatric surgery, low-calorie diets (LCD), or carbohydrate restriction (LC). Bariatric surgery has been recommended for the treatment of T2D since 2016 by an international diabetes consensus group. Both the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) now recommend a LC eating pattern and support the short-term use of LCD for weight loss. However, only T2D treatment, not reversal, is discussed in their guidelines. Conclusion: Given the state of evidence for T2D reversal, healthcare providers need to be educated on reversal options so they can actively engage in counseling patients who may desire this approach to their disease.

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  • This process has the potential to be reversible following changes in diet quantity and quality, as shown with calorie restriction, fasting, time-restricted eating, gastric bypass surgery, low saturated fat and low glycemic diets.

    “This process has the potential to be reversible following changes in diet quantity and quality, as has been shown to occur with calorie restriction, fasting, time-restricted eating, gastric bypass surgery, low saturated fat and low glycemic diets [168,170,173].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [168]

    The Bariatric Surgery and Low-Calorie Diets sections report type 2 diabetes reversal or remission after surgery and substantial calorie restriction; the latter also describes a protein-sparing modified fast. The Carbohydrate-Restricted Diets section reports improved measures with a low-glycemic diet, but does not establish reversal from that diet. The cited review does not establish reversal through time-restricted eating or a low-saturated-fat diet (no page numbers are available in our copy). (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Numerous studies have shown that dietary modification, or treatment with probiotics or synbiotics, has the potential to restore normal insulin function.

    “Numerous studies have shown that dietary modification [168,169,170], or treatment with probiotics or synbiotics, has the potential to restore normal insulin function [57,171].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [168]

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References 119 · Cited by 170

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  1. [3]Home P. Riddle M. Cefalu W.T. Bailey C.J. Del Prato S. Leroith D. Schemthaner G. van Gaal L. Raz I. Insulin therapy in people with Type 2 diabetes: Opportunities and challenges Diabetes Care 2014 37 1499 1508 10.2337/dc13-2743 24855154 PMC5131884 · DOI
  2. [5]Davies M.J. D’Alessio D.A. Fradkin J. Kernan W.N. Mathieu C. Mingrone G. Rossing P. Tsapas A. Wexler D.J. Buse J.B. Management of hyperglycemia in Type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care 2018 41 2669 2701 10.2337/dci18-0033 30291106 PMC6245208 · DOI · Paper page
  3. [6]Ramos-Levi A.M. Cabrerizo L. Matia P. Sanchez-Pernaute A. Torres A.J. Rubio M.A. Which criteria should be used to define type 2 diabetes remission after bariatric surgery BMC Surgery 2013 13 8 10.1186/1471-2482-13-8 23537494 PMC3616830 · DOI
  4. [9]Buse J.B. Caprio S. Cefalu W.T. Ceriello A. Del Prato S. Inzucchi S.E. McLaughlin S. Phillips G.L. II Robertson R.P. Rubino F. How do we define cure of diabetes? Diabetes Care 2009 32 2133 2135 10.2337/dc09-9036 19875608 PMC2768219 · DOI · Paper page
  5. [12]Rubino F. Nathan D. Eckel R.H. Schauer P.R. Alberti K.G. Zimmet P.Z. Del Prato S. Ji L. Sadikot S.M. Herman W.H. Delegates of the 2nd Diabetes Surgery Summit. Metabolic surgery in the treatment algorithm for type 2 diabetes: A joint statement by International Diabetes Organizations Diabetes Care 2016 39 861 877 10.2337/dc16-0236 27222544 · DOI
  6. [13]Anhe F.F. Varin T.V. Schertzer J.D. Marette A. The Gut Microbiota as a Mediator of Metabolic Benefits after Bariatric Surgery Can. J. Diabetes 2017 41 439 447 10.1016/j.jcjd.2017.02.002 28552651 · DOI · Paper page
  7. [14]Medina D.A. Pedreros J.P. Turiel D. Quezada N. Pimentel F. Escalona A. Garrido D. Distinct patterns in the gut microbiota after surgical or medical therapy in obese patients PeerJ 2017 5 e3443 10.7717/peerj.3443 28649469 PMC5480389 · DOI · Paper page
  8. [15]Magouliotis D.E. Tasiopoulou V.S. Sioka E. Chatedaki C. Zacharoulis D. Impact of Bariatric Surgery on Metabolic and Gut Microbiota Profile: A Systematic Review and Meta-analysis Obes. Surg. 2017 27 1345 1357 10.1007/s11695-017-2595-8 28265960 · DOI
  9. [17]Kaska L. Sledzinski T. Chomiczewska A. Dettlaff-Pokora A. Swierczynski J. Improved glucose metabolism following bariatric surgery is associated with increased circulating bile acid concentrations and remodeling of the gut microbiome World J. Gastroenterol. 2016 22 8698 8719 10.3748/wjg.v22.i39.8698 27818587 PMC5075546 · DOI
  10. [18]Penney N.C. Kinross J. Newton R.C. Purkayastha S. The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review Int. J. Obes. (Lond). 2015 39 1565 1574 10.1038/ijo.2015.115 26081915 · DOI
  11. [19]Sweeney T.E. Morton J.M. The human gut microbiome: A review of the effect of obesity and surgically induced weight loss JAMA Surg. 2013 148 563 569 10.1001/jamasurg.2013.5 23571517 PMC4392891 · DOI
  12. [20]Rubino F. Gagner M. Potential of surgery for curing type 2 diabetes mellitus Ann. Surg. 2002 236 554 559 10.1097/00000658-200211000-00003 12409659 PMC1422611 · DOI
  13. [21]Cohen R. Caravatto P.P. Correa J.L. Noujaim P. Petry T.Z. Salles J.E. Schiavon C.A. Glycemic control after stomach-sparing duodenal-jejunal bypass surgery in diabetic patients with low body mass index Surg. Obes. Relat. Dis. 2012 8 375 380 10.1016/j.soard.2012.01.017 22410638 · DOI
  14. [22]Federico A. Dallio M. Tolone S. Gravina A.G. Patrone V. Romano M. Tuccillo C. Mozzillo A.L. Amoroso V. Misso G. Gastrointestinal Hormones, Intestinal Microbiota and Metabolic Homeostasis in Obese Patients: Effect of Bariatric Surgery In Vivo 2016 30 321 330 27107092
  15. [23]Peat C.M. Kleiman S.C. Bulik C.M. Carroll I.M. The Intestinal Microbiome in Bariatric Surgery Patients Eur. Eat. Disord. Rev. 2015 23 496 503 10.1002/erv.2400 26426680 PMC5022764 · DOI
  16. [24]Sweeney T.E. Morton J.M. Metabolic surgery: Action via hormonal milieu changes, changes in bile acids or gut microbiota? A summary of the literature Best Pract. Res. Clin. Gastroenterol. 2014 28 727 740 10.1016/j.bpg.2014.07.016 25194186 PMC4399638 · DOI
  17. [25]Ma I.T. Madura J.A. Gastrointestinal Complications after Bariatric Surgery Gastroenterol. Hepatol. (N Y). 2015 11 526 535 27118949 PMC4843041
  18. [26]Rubino F. Schauer P.R. Kaplan L.M. Cummings D.E. Metabolic surgery to treat type 2 diabetes: Clinical outcome and mechanisms of action Annu. Rev. Med. 2010 61 393 411 10.1146/annurev.med.051308.105148 20059345 · DOI
  19. [27]Abraham A. Ikramuddin S. Jahansouz C. Arafat F. Hevelone N. Leslie D. Trends in bariatric surgery: Procedure selection, revisional surgeries, and readmissions Obes. Surg. 2016 26 1371 1377 10.1007/s11695-015-1974-2 26715330 · DOI
  20. [29]Eisenbarg D. Azagury D.E. Ghiassi S. Grover B.T. Ki J.J. ASMBS position statement on postprandial hyperinsulinemic hypoglycemia after bariatric surgery Surg. Obes. Relat. Dis. 2017 13 371 378 10.1016/j.soard.2016.12.005 28110984 · DOI
  21. [30]Pories W.J. Mehaffey J.H. Staton K.M. The surgical treatment of type two diabetes mellitus Surg Clin. N. Am. 2011 91 821 836 10.1016/j.suc.2011.04.008 21787970 · DOI
  22. [31]Purnell J.Q. Selzer F. Wahed A.S. Pender J. Pories W. Pomp A. Dakin G. Mitchell J. Garcia L. Staten M.A. Type 2 Diabetes Remission Rates After Laparoscopic Gastric Bypass and Gastric Banding: Results of the Longitudinal Assessment of Bariatric Surgery Study Diabetes Care 2016 39 1101 1107 10.2337/dc15-2138 27289123 PMC4915561 · DOI
  23. [32]Salminen P. Helmio M. Ovaska J. Juuti A. Leivonen M. Peromaa-Haavista P. Hurme S. Soinio M. Nuutila P. Victorzon M. Effect of laparoscopic sleeve gastrectomy vs. laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: The SLEEVEPASS randomized clinical trial JAMA 2018 319 241 254 10.1001/jama.2017.20313 29340676 PMC5833550 · DOI · Paper page
  24. [34]Kashyap S.R. Bhatt D.L. Wolski K. Watanabe R.M. Abdul-Ghani M. Abood B. Pothier C.E. Brethauer S. Nissen S. Gupta M. Metabolic effects of bariatric surgery in patients with moderate obesity and type 2 diabetes: Analysis of a randomized control trial comparing surgery with intensive medical treatment Diabetes Care 2013 36 2175 2182 10.2337/dc12-1596 23439632 PMC3714483 · DOI
  25. [35]Schauer P.R. Bhatt D.L. Kirwan J.P. Wolski K. Aminian A. Brethauer S.A. Navaneethan S.D. Singh R.P. Pothier C.E. Nissen S.E. Bariatric surgery versus intensive medical therapy for diabetes: 5-year outcomes N. Engl. J. Med. 2017 376 641 651 10.1056/NEJMoa1600869 28199805 PMC5451258 · DOI · Paper page
  26. [36]Doble B. Wordsworth S. Rogers C.A. Welbourn R. Byrne J. Blazeby J.M. By-Band-Sleeve Trial Management Group What are the real procedural costs of bariatric surgery? A systematic literature review of published cost analyses Obes. Surg. 2017 27 2179 2192 10.1007/s11695-017-2749-8 28550438 PMC5509820 · DOI
  27. [37]Warren J.A. Ewing J.A. Hale A.L. Blackhurst D.W. Bour E.S. Scott J.D. Cost-effectiveness of bariatric surgery: Increasing the economic viability of the most effective treatment for type II diabetes mellitus Am. Surgeon. 2015 81 807 811 26215244
  28. [38]Klein S. Ghosh A. Cremieux P.Y. Eapen S. McGavock T.J. Economic impact of the clinical benefits of bariatric surgery in diabetes patients with BMI ≥ 35kg/m2 Obesity 2011 19 581 587 10.1038/oby.2010.199 20829800 PMC3721344 · DOI
  29. [40]Schiavo L. Pilone V. Rossetti G. Barbarisi A. Cesaretti M. Iannelli A. A 4-Week Preoperative Ketogenic Micronutrient-Enriched Diet Is Effective in Reducing Body Weight, Left Hepatic Lobe Volume, and Micronutrient Deficiencies in Patients Undergoing Bariatric Surgery: A Prospective Pilot Study Obes. Surg. 2018 28 2215 2224 10.1007/s11695-018-3145-8 29502279 · DOI
  30. [41]Leonetti F. Campanile F.C. Coccia F. Capoccia D. Alessandroni L. Puzziello A. Coluzzi I. Silecchia G. Very low-carbohydrate ketogenic diet before bariatric surgery: Prospective evaluation of a sequential diet Obes. Surg. 2015 25 64 71 10.1007/s11695-014-1348-1 25005809 · DOI
  31. [42]Gumbs A.A. Pomp A. Gagner M. Revisional bariatric surgery for inadequate weight loss Obes. Surg. 2007 17 1137 1145 10.1007/s11695-007-9209-9 18074485 · DOI
  32. [43]Velapati S.R. Shah M. Kuchkuntla A.R. Abu-Dayyeh B. Grothe K. Hurt R.T. Mundi M.S. Weight Regain After Bariatric Surgery: Prevalence, Etiology, and Treatment Curr. Nutr. Rep. 2018 7 329 334 10.1007/s13668-018-0243-0 30168043 · DOI
  33. [44]Shoar S. Nguyen T. Ona M.A. Reddy M. Anand S. Alkuwari M.J. Saber A.A. Roux-end-Y gastric bypass reversal: A systematic review Surg. Obes. Relat. Dis. 2016 12 1366 1372 10.1016/j.soard.2016.02.023 27260651 · DOI
  34. [45]Bojsen-Moller K.N. Mechanisms of improved glycemic control after Roux-en-Y gastric bypass Dan. Med. J. 2015 62 B5057 25872541
  35. [46]Pories W.J. Swanson M.S. MacDonald K.G. Long S.B. Morris P.G. Brown B.M. Barakat H.A. de Ramon R.A. Israel G. Dolezal J.M. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus Ann. Surg. 1995 222 339 350 10.1097/00000658-199509000-00011 7677463 PMC1234815 · DOI · Paper page
  36. [47]Sjostrom L. Lindroos A.K. Peltonen M. Torgerson J. Bouchard C. Carlsson B. Dahlgren S. Larsson B. Narbro K. Sjostrom D. Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery N. Engl. J. Med. 2004 351 2683 2693 10.1056/NEJMoa035622 15616203 · DOI · Paper page
  37. [48]Bistrian B.R. Blackburn G.L. Flatt J.P. Sizer J. Scrimshaw N.S. Sherman M. Nitrogen metabolism and insulin requirements in obese diabetic adults on a protein-sparing modified fast Diabetes 1976 25 494 504 10.2337/diab.25.6.494 1278601 · DOI · Paper page
  38. [49]Bauman W.A. Schwartz E. Rose H.G. Eisenstein H.N. Johnson D.W. Early and long term effects of acute caloric deprivation in obese diabetic patients Am. J. Med. 1988 85 38 46 10.1016/0002-9343(88)90500-1 3291612 · DOI
  39. [50]Hughes T.A. Gwynne J.T. Switzer B.R. Herbst C. White G. Effects of caloric restriction and weight loss on glycemic control, insulin release and resistance, and atherosclerotic risk in obese patients with type II diabetes mellitus Am. J. Med. 1984 77 7 17 10.1016/0002-9343(84)90429-7 6377892 · DOI
  40. [51]Hammer S. Snel M. Lamb H.J. Jazet I.M. van der Meer R.W. Pijl H. Meinders E.A. Romijn J.A. de Roos A. Smit J.W. Prolonged caloric restriction in obese patients with type 2 diabetes mellitus decreases myocardial triglyceride content and improves myocardial function J. Am. Coll. Cardiol. 2008 52 1006 1012 10.1016/j.jacc.2008.04.068 18786482 · DOI
  41. [52]Snel M. Jonker J.T. Hammer S. Kerpershoek G. Lamb H.J. Meinders A.E. Pijl H. de Roos A. Romijn J.A. Smit J.W.A. Long-term beneficial effect of a 16-week very low calorie diet on pericardial fat in obese type 2 diabetes mellitus patients Obesity 2012 20 1572 1576 10.1038/oby.2011.390 22282049 · DOI · Paper page
  42. [53]Paisey R.B. Harvey P. Rice S. Belka I. Bower L. Dunn M. Taylor P. Paisey R.M. An intensive weight loss programme in established type 2 diabetes and controls: Effect on weight and atherosclerosis risk factors at 1 year Diabet. Med. 1998 15 73 79 10.1002/(SICI)1096-9136(199801)15:1<73::AID-DIA516>3.0.CO;2-F 9472867 · DOI
  43. [55]Damms-Machado A. Weser G. Bischoff SC. Micronutrient deficiency in obese subjects undergoing low calorie diet Nutr. J. 2012 11 10.1186/1475-2891-11-34 22657586 PMC3404899 · DOI · Paper page
  44. [56]Gardner C.D. Kim S. Bersamin A. Dopler-Nelson M. Otten J. Oelrich B. Cherin R. Micronutrient quality of weight-loss diets that focus on macronutrients: Results from the A to Z study Am. J. Clin. Nutr. 2010 92 304 312 10.3945/ajcn.2010.29468 20573800 PMC2904033 · DOI · Paper page
  45. [57]Ryan D.H. Espeland M.A. Foster G.D. Haffner S.M. Hubbard V.S. Johnson K.C. Kahn S.E. Knowler W.C. Yanovski S.Z. Look AHEAD Research Group Look AHEAD (Action for Health in Diabetes): Design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes Control Clin Trials. 2003 24 610 628 14500058
  46. [58]Gregg E.W. Chen H. Wagenknecht L.E. Clark J.M. Delahanty L.M. Bantle J. Pownall H.J. Johnson K.C. Safford M.M. Kitabchi A.E. Association of an intensive lifestyle intervention with remission of type 2 diabetes JAMA. 2012 308 2489 2496 10.1001/jama.2012.67929 23288372 PMC4771522 · DOI · Paper page
  47. [59]Mottalib A. Sakr M. Shehabeldin M. Hamdy O. Diabetes remission after nonsurgical intensive lifestyle intervention in obese patients with Type 2 diabetes J. Diabetes Res. 2015 468704 10.1155/2015/468704 26114120 PMC4465710 · DOI · Paper page
  48. [60]Ades P.A. Savage P.D. Marney A.M. Harvey J. Evans K.A. Remission of recently diagnosed type 2 diabetes mellitus with weight loss and exercise J. Cardiopulm. Rehabil. Prev. 2015 35 193 197 10.1097/HCR.0000000000000106 25636149 PMC4409919 · DOI
  49. [61]Bhatt A.A. Choudhari P.K. Mahajan R.R. Sayyad M.G. Pratyush D.D. Hasan I. Javherani R.S. Bothale M.M. Purandare V.B. Unnikrishnan A.G. Effect of a low-calorie diet on restoration of normoglycemia in obese subjects with Type 2 diabetes Indian J. Endocrinol. Metab. 2017 21 776 780 28989891 PMC5628553
  50. [66]McInnes N. Smith A. Otto R. Vandermey J. Punthakee Z. Sherifali D. Balasubramaniam K. Hall S. Gerstein HC. Piloting a remission strategy in type 2 diabetes: Results of a randomized controlled trial J. Clin. Endocrinol. Metab. 2017 102 1596 1605 10.1210/jc.2016-3373 28324049 · DOI
  51. [67]Fothergill E. Guo J. Howard L. Kerns J.C. Knuth N.D. Brychta R. Chen K.Y. Skarulis M.C. Walter M. Walter P.J. Persistent metabolic adaptation 6 years after “The Biggest Loser” competition Obesity 2016 24 1612 1619 10.1002/oby.21538 27136388 PMC4989512 · DOI · Paper page
  52. [69]Campbell W.R. Dietetic treatment in diabetes mellitus Can. Med. Assoc. J. 1923 13 487 492 20314727 PMC1707079
  53. [70]Westman E.C. Yancy W.S. Humphreys M. Dietary treatment of diabetes mellitus in the pre-insulin era (1914–1922) Perspect. Biol. Med. 2006 49 77 83 10.1353/pbm.2006.0017 16489278 · DOI
  54. [71]Arky R. Wylie-Rosett J. El-Beheri B. Examination of current dietary recommendations for individuals with diabetes mellitus Diabetes Care 1982 5 59 63 10.2337/diacare.5.1.59 6754302 · DOI
  55. [72]Anderson J.W. Geil P.B. New perspectives in nutrition management of diabetes mellitus Am. J. Med. 1988 85 159 165 10.1016/0002-9343(88)90410-X 2848414 · DOI
  56. [73]American Diabetes Association Summary of Revisions: Standards of Medical Care in Diabetes-2019 Diabetes Care 2019 42 S4 S6 33298411
  57. [75]Westman E.C. Feinman R.D. Mavropoulos J.C. Vernon M.C. Volek J.S. Wortman J.A. Yancy W.S. Phinney S.D. Low carbohydrate nutrition and metabolism Am. J. Clin. Nutr. 2007 86 276 284 10.1093/ajcn/86.2.276 17684196 · DOI
  58. [77]Miyashita Y. Koide N. Ohtsuka M. Ozaki H. Itoh Y. Oyama T. Uetake T. Ariga K. Shirai K. Beneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity Diabetes Res. Clin. Pract. 2004 65 235 241 10.1016/j.diabres.2004.01.008 15331203 · DOI
  59. [78]Jönsson T. Granfeldt Y. Ahren B. Branell U.C. Pålsson G. Hansson A. Söderström M. Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: A randomized cross-over pilot study Cardiovasc. Diabetol. 2009 8 3 10.1186/1475-2840-8-35 19604407 PMC2724493 · DOI · Paper page
  60. [80]Daly M.E. Paisey R. Paisey R. Millward B.A. Eccles C. Williams K. Hammersley S. MacLeod K.M. Gale T.J. Short-term effects of severe dietary carbohydrate-restriction advice in type 2 diabetes: A randomized controlled trial Diabet. Med. 2006 23 15 20 10.1111/j.1464-5491.2005.01760.x 16409560 · DOI
  61. [81]Dyson P.A. Beatty S. Matthews D.R. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects Diabet. Med. 2007 24 1430 1435 10.1111/j.1464-5491.2007.02290.x 17971178 · DOI
  62. [82]Wolever T.M. Gibbs A.L. Mehling C. Chiasson J.L. Connelly P.W. Josse R.G. Leiter L.A. Maheux P. Rabasa-Lhoret R. Rodger N.W. The Canadian trial of carbohydrates in diabetes (CCD), a 1-yr controlled of low-glycemic index dietary carbohydrate in type 2 diabetes: No effect on glycated hemoglobin but reduction in C-reactive protein Am. J. Clin. Nutr. 2008 87 114 125 10.1093/ajcn/87.1.114 18175744 · DOI · Paper page
  63. [88]Guldbrand H. Dizdar B. Bunjaku B. Lindström T. Bachrach-Lindström M. Fredrikson M. Östgren C.J. Nystrom F.H. In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss Diabetologi. 2012 55 2118 2127 10.1007/s00125-012-2567-4 PMC3390696 22562179 · DOI · Paper page
  64. [91]Tay J. Thompson C.H. Luscombe-Marsh N.D. Wycherley T.P. Noakes M. Buckley J.D. Wittert G.A. Yancy W.S. Jr. Brinkworth G.D. Effects of an energy-restricted low-carbohydrate, high unsaturated fat/low saturated fat diet versus a high-carbohydrate, low-fat diet in type 2 diabetes: A 2-year randomized clinical trial Diabetes Obes. Metab. 2018 20 858 871 10.1111/dom.13164 29178536 · DOI · Paper page
  65. [92]Wang L.L. Wang Q. Hong Y. Ojo O. Jiang Q. Hou Y.Y. Huang Y.-H. Wang X.H. The effect of low-carbohydrate diet on glycemic control in patients with type 2 diabetes mellitus Nutrients 2018 10 661 10.3390/nu10060661 29882884 PMC6024764 · DOI
  66. [93]Larsen R.N. Mann N.J. Maclean E. Shaw J.E. The effect of high-protein, low-carbohydrate diets in the treatment of type 2 diabetes: A 12 month randomised controlled trial Diabetologia 2011 54 731 740 10.1007/s00125-010-2027-y 21246185 · DOI · Paper page
  67. [94]Sato J. Kanazawa A. Makita S. Hatae C. Komiya K. Shimizu T. Ikeda F. Tamura Y. Ogihara T. Mita T. A randomized controlled trial of 130g/day low-carbohydrate diet in type 2 diabetes with poor glycemic control Clin. Nutr. 2017 36 992 1000 10.1016/j.clnu.2016.07.003 27472929 · DOI
  68. [95]Sanada M. Kabe C. Hata H. Uchida J. Inoue G. Tsukamoto Y. Yamada Y. Irie J. Tabata S. Tabata M. Efficacy of a moderately low carbohydrate diet in a 36-month observational study of Japanese patients with Type 2 diabetes Nutrients 2018 10 528 10.3390/nu10050528 29695055 PMC5986408 · DOI
  69. [96]Boden G. Sargrad K. Homko C. Mozzoli M. Stein T.P. Effect of a low carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes Ann. Intern. Med. 2005 142 403 411 10.7326/0003-4819-142-6-200503150-00006 15767618 · DOI · Paper page
  70. [99]Krebs J.D. Bell D. Hall R. Parry-Strong A. Docherty P.D. Clarke K. Chase J.G. Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes J. Am. Coll. Nutr. 2013 32 11 17 10.1080/07315724.2013.767630 24015695 · DOI · Paper page
  71. [101]Sasakabe T. Haimoto H. Umegaki H. Wakai K. Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes Diabetes Metab. Syndr. Obes. 2011 4 167 174 10.2147/DMSO.S19635 21779148 PMC3138148 · DOI
  72. [102]Nielsen J.V. Joensson E.A. Low carbohydrate diet in type 2 diabetes: Stable improvement of bodyweight and glycemic control during 44 months follow-up Nutr. Metab. 2008 5 14 10.1186/1743-7075-5-14 18495047 PMC2424054 · DOI · Paper page
  73. [103]Dashti H.M. Mathew T.C. Khadada M. Al-Mousawi M. Talib H. Asfar S.K. Behbahani A.I. Al-Zaid N.S. Beneficial effects of ketogenic diet in obese diabetic subjects Mol. Cell Biochem. 2007 302 249 256 10.1007/s11010-007-9448-z 17447017 · DOI
  74. [104]Yancy W.S. Foy M. Chalecki A.M. Vernon A.C. Westman E.C. A low carbohydrate, ketogenic diet to treat type 2 diabetes Nutr. Metab. 2005 2 34 10.1186/1743-7075-2-34 16318637 PMC1325029 · DOI
  75. [105]Dashti H.M. Mathew T.C. Hussein T. Asfar S.K. Behbahani A. Khoursheed M.A. Al-Sayer H.M. Bo-Abbas Y.Y. Al-Zaid N.S. Long-term effects of a ketogenic diet in obese patients Exp. Clin. Cardiol. 2004 9 200 205 19641727 PMC2716748
  76. [106]Shai I. Schwarzfuchs D. Henkin Y. Shahar D.R. Witkow S. Greenberg I. Golan R. Fraser D. Bolotin A. Vardi H. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet N. Engl. J. Med. 2008 359 229 241 10.1056/NEJMoa0708681 18635428 · DOI · Paper page
  77. [107]Elhayany A. Lustman A. Abel R. Attal-Singer J. Vinker S. A low carbohydrate Mediterranean diet improves cardiovascular risk factors and diabetes control among overweight patients with type 2 diabetes mellitus: A 1-year prospective randomized intervention study Diabetes Obes. Metab. 2010 12 204 209 10.1111/j.1463-1326.2009.01151.x 20151996 · DOI · Paper page
  78. [109]Snorgaard O. Poulsen G.M. Andersen H.K. Astrup A. Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes BMJ Open Diabetes Res. Care. 2017 5 e000354 10.1136/bmjdrc-2016-000354 28316796 PMC5337734 · DOI · Paper page
  79. [110]Bhanpuri N.H. Hallberg S.J. Williams P.T. McKenzie A.L. Ballard K.D. Campbell W.W. McCarter J.P. Phinney S.D. Volek J.S. Cardiovascular disease risk factor responses to a type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at one year: An open label, non-randomized, controlled study Cardiovasc. Diabetol. 2018 17 56 10.1186/s12933-018-0698-8 29712560 PMC5928595 · DOI · Paper page
  80. [111]Wang G.F. Yan Y.X. Yin D. Hui Y. Zhang J.P. Han G.J. Ma N. Wu Y. Xu J.Z. Yang T. Predictive factors of Type 2 diabetes mellitus remission following bariatric surgery: A Meta-analysis Obes. Surg. 2015 25 199 208 10.1007/s11695-014-1391-y 25103403 PMC4297287 · DOI
  81. [112]Yan W. Bai R. Li Y. Xu J. Zhong Z. Xing Y. Yan M. Lin Y. Song M. Analysis of predictors of type 2 diabetes mellitus remission after roux-en-Y gastric bypass in 101 Chinese patients Obes. Surg. 2019 10.1007/s11695-019-03783-x 30798440 · DOI
  82. [113]Brehm B.J. Seeley R.J. Daniels S.R. D’Alessio D.A. A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women J. Clin. Endocrinol. Metab. 2003 88 1617 1623 10.1210/jc.2002-021480 12679447 · DOI · Paper page
  83. [115]Westman E.C. Yancy W.S. Edman J.S. Tomlin K.F. Perkins CE. Effect of 6-month adherence to a very low carbohydrate diet program Am. J. Med. 2002 113 30 36 10.1016/S0002-9343(02)01129-4 12106620 · DOI
  84. [116]Nuttall F.Q. Gannon M.C. The metabolic response to a high-protein, low-carbohydrate diet in men with type 2 diabetes mellitus Metabolism 2006 55 243 251 10.1016/j.metabol.2005.08.027 16423633 · DOI
  85. [117]Min T. Barry J.D. Stephens J.W. Predicting the Resolution of Type 2 Diabetes after Bariatric Surgical Procedures: A Concise Review J. Diabetes Metab. 2015 6 617

Authors
Hallberg, S. J., Gershuni, V. M., Hazbun, T. L., & Athinarayanan, S. J.
Affiliations
  • Indiana University Health (US)
  • University of Pennsylvania (US)
  • Virta Health, 535 Mission Street, San Francisco, CA 94105, USA
Corresponding author
Hallberg, Sarah J
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2019-04-01
Volume
11
Issue
4
Pages
766
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu11040766
PMC
PMC6520897
OpenAlex
W2932484301
Cited by
170
References
119
Citations by year
2026: 9 · 2025: 16 · 2024: 33 · 2023: 27 · 2022: 29 · 2021: 24 · 2020: 22 · 2019: 10
FWCI
4.38
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • IUScholarWorks (Indiana University) (submittedVersion, cc-by-nc-nd)
Funders
  • National Institutes of Health (TL1TR001880)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, diabetes remission, diabetes reversal, bariatric surgery, hypocaloric diet, carbohydrate restriction, weight loss, diabetes management guidelines, patient counseling
MeSH terms
Diabetes Mellitus, Type 2, Europe, Humans, Weight Loss, Caloric Restriction, Bariatric Surgery, Diet, Carbohydrate-Restricted

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