Low-fat vegan diet can cut liver fat by a third and improve insulin function in adults with type 2 diabetes

From medicalxpress.com

By Physicians Committee for Responsible Medicine 

Adults with type 2 diabetes who followed a low-fat vegan diet for 16 weeks, eating as much as they wanted, with no calorie counting or portion control, lost weight, reduced fat build-up in the liver and abdomen and improved insulin sensitivity and beta-cell function, according to a new clinical trial published in BMJ Open Diabetes Research & Care.

The study, led by researchers at the Physicians Committee for Responsible Medicine in collaboration with the Yale School of Medicine, is the first to simultaneously measure liver fat, muscle fat, visceral fat and tissue advanced glycation end products (AGEs) in a single plant-based dietary intervention in people with type 2 diabetes, offering a more complete picture of how diet reverses the underlying mechanisms that drive the disease.

Credit: Unsplash/CC0 Public Domain

"For years, people with diabetes have been told to count calories and measure portions. This study shows that a simple shift in what you eat—toward vegetables, whole grains, legumes and fruit—can reduce the fat clogging the liver by a third and improve how the pancreas makes insulin, without anyone having to count a single calorie," said Hana Kahleova, M.D., Ph.D., the lead author of the study and director of clinical research at the Physicians Committee for Responsible Medicine.

Key findings include:

• Body weight fell by an average of 6.0 kg (13.2 pounds) (6.6%), driven mainly by loss of fat mass (-4.2 kg (-9.3 pounds)); visceral (abdominal) fat volume dropped by 290 cm³.
• Hepatocellular (liver) lipid content, a key driver of insulin resistance, fell by 33%.
• Tissue accumulation of advanced glycation end products (AGEs), which contribute to insulin resistance and beta-cell damage, decreased significantly.
• Insulin resistance (HOMA-IR) improved, and insulin sensitivity (OGIS and PREDIM) increased.
• Multiple markers of pancreatic beta-cell function improved, including glucose-stimulated insulin secretion, beta-cell glucose sensitivity, rate sensitivity and potentiation factor.
• HbA1c fell by 1.0 percentage point, and total and LDL cholesterol both decreased significantly.
• These changes occurred without a prescribed calorie target; participants were counselled to eat to satiety on a low-fat, plant-based diet (about 75% of calories from carbohydrates, 15% from protein and 10% from fat).

"This research adds to a growing body of evidence that food can work like medicine for people with diabetes. When patients don't have to weigh their portions or track every calorie, healthy eating becomes something they can actually sustain, and that is when we see real, lasting metabolic change," said Kahleova.

More information

Hana Kahleova et al, Changes in ectopic lipids, insulin sensitivity, and beta cell function after a low-fat vegan diet in adults with type 2 diabetes: a 16-week single-arm clinical trial, BMJ Open Diabetes Research & Care (2026). DOI: 10.1136/bmjdrc-2026-006472

https://medicalxpress.com/news/2026-10-fat-vegan-diet-liver-insulin.html

Can diabetes damage your liver? Doctor flags early signs and prevention tips

From hindustantimes.com

Find out how diabetes can influence your liver health. If you are diabetic, you may be at an increased risk of fatty liver

The body's systems are closely interconnected. So a condition primarily associated with one organ can also affect others. Diabetes is commonly linked to the pancreas and blood sugar regulation, but its effects can go much beyond, affecting other organs, including the liver. Let's hear from an expert about this connection.

Dr Lubna Chingili, chief medical officer at the Global Innovation Centre, NURA, confirmed that high blood sugar can also affect the liver, increasing the chances of developing fatty liver disease. She explained, “Type 2 diabetes and insulin resistance cause excess glucose to be converted into fat, which gets stored in the liver. Over time, this can lead to fatty liver disease (MASLD). Persistently high blood sugar also increases inflammation and oxidative stress, raising the risk of liver scarring (fibrosis) and, in some cases, cirrhosis.”

To put it simply, when the body cannot use insulin effectively, excess glucose may be converted into fat and stored in the liver, and as this fat further accumulates, it gives rise to fatty liver disease.

                                               Know the early warning signs of liver damage. (Shutterstock)

What are the early warning signs that may mean liver damage in a person with diabetes?

Usually, fatty liver disease's signs are tough to identify in the early stages, as it silently progresses without any noticeable symptoms. Even when any signs do appear, they can easily be mistaken for other lifestyle-related concerns, such as stress, exhaustion, or digestive discomfort.

But if you are vigilant, you can detect the early signs. Dr Chingili said, “When early signs do appear, they may include persistent fatigue, a feeling of heaviness or mild discomfort in the upper right side of the abdomen, bloating, or unexplained changes in blood sugar control.”

This is why the doctor recommended routine testing, as it is more helpful than relying on visible symptoms alone. As per Dr Chingili, the first clue may be an abnormal liver function test or fatty liver detected through an ultrasound during a routine health check-up. Therefore, although early liver disease may remain silent, regular screening can aid people with diabetes detect liver damage before it progresses.

What are the management tips for a person with diabetes to protect their liver?

Managing diabetes consistently lowers fatty liver disease risks, too. Dr Chingili recommended the following measures:

• Control blood sugar levels: Monitor and manage blood sugar consistently, as persistently high levels may increase liver fat accumulation.
• Maintain a healthy weight: Reduces risk of fat storage in the liver
• Exercise regularly: Physical activity ensures weight management, which is necessary for metabolic health and diabetes management.
• Follow a balanced diet: Limit refined carbohydrates and added sugars, which may lead to high blood sugar and, in turn, fat accumulation in the liver.
• Limit or avoid alcohol: Alcohol stresses the liver and may worsen existing liver problems.
• Be cautious with medicines and supplements: Avoid unnecessary medications or supplements that may affect the liver.
• Get regular health check-ups: Go for liver function tests to detect any issues early.
• Manage blood pressure and cholesterol: They also affect liver health and should be managed alongside blood sugar.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

https://www.hindustantimes.com/lifestyle/health/can-diabetes-damage-your-liver-doctor-flags-early-signs-and-prevention-tips-101786111419326.html

 

Type 2 Diabetes timeline: What happens inside the body in the first 10 years after diagnosis

From indianexpress.com

Understand how the first decade of diabetes silently shapes your long-term cardiovascular and metabolic health

A diabetes diagnosis often feels like a single moment in time, but its impact unfolds gradually inside the body over the years. What makes this condition particularly complex is that much of the early damage is not immediately visible. While blood sugar levels may fluctuate day to day, the long-term effects build silently.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

In the first decade after diagnosis, the body begins to adapt — and sometimes struggle — with persistently elevated glucose levels. Understanding this timeline is essential, not to alarm but to inform. From early metabolic changes to potential complications involving internal organs, the first ten years can set the tone for long-term health outcomes. With the right interventions, some of these effects can be delayed or even prevented, but it requires clarity on what is happening beneath the surface and when.

             Diabetes can quietly affect multiple organs over time (Source: AI Generated)

Key internal changes happening in the body

Kanikka Malhotra, Consultant Dietician & Diabetes Educator, tells indianexpress.com, “Most people assume diabetes is simply about managing sugar levels, but what is actually happening inside the body tells a far more complex story. In the first 5 to 10 years after diagnosis, chronically high blood glucose quietly begins damaging the body’s infrastructure from the inside out.”

She adds that one of the earliest changes happens in the blood vessels. Sugar molecules attach themselves to proteins and fats in a process called glycation, gradually making blood vessels stiffer and narrower. This affects both the large vessels supplying the heart and brain and the tiny capillaries serving the eyes, kidneys and nerves. “The nervous system begins taking hits too, particularly in the feet and hands, often without any obvious symptoms for years. The kidneys start showing early signs of stress. The eyes develop fragile, leaky blood vessels. And running beneath all of this is a steady current of systemic inflammation that silently accelerates the damage, while the pancreas continues losing its ability to produce insulin on its own.”

Which organs are most vulnerable to early damage?

What makes diabetes particularly unforgiving is how quietly it works. By the time most people feel something is wrong, significant internal damage may already have taken place over several years. Malhotra stresses, “The kidneys are often among the first to suffer. High blood sugar puts relentless pressure on their delicate filtering units, and without intervention, this progresses from early warning signs in urine tests to serious kidney disease over time.”

She adds that the eyes follow a similar silent path. Retinal blood vessels weaken, bleed or grow abnormally, and vision loss can set in well within the first decade if blood sugar remains uncontrolled. The heart and arteries age faster under diabetic conditions, sharply raising the risk of heart attacks and strokes. “The nerves in the feet deteriorate gradually, sometimes to the point where injuries go completely unnoticed, raising the risk of serious infections and amputations. The liver, too, tends to accumulate fat, which worsens insulin resistance and creates a damaging cycle. The sobering reality is that most of this damage builds up in complete silence.”

Lifestyle changes to slow down or prevent long-term complications

The first ten years after a diabetes diagnosis are not just a period of damage; they are genuinely the most powerful window of opportunity to change the trajectory of the disease. Malhotra notes, “Scientists call this the legacy effect, meaning the habits and choices made early on leave a lasting biological imprint on how the disease unfolds for decades to come. Food and nutrition are the most powerful tools available. A plan built around whole grains, vegetables, lean proteins and healthy fats helps stabilise blood sugar, calm inflammation and protect blood vessels.”

Even a modest weight loss of 5 to 10 percent of body weight can meaningfully improve how the body responds to insulin and reduce pressure on the kidneys, heart and liver. “Regular movement, both walking and strength-based exercise, helps muscles absorb glucose more effectively and brings down HbA1c levels. Managing blood sugar, blood pressure, and cholesterol together is critical, as all three compound the damage when left unchecked. From my perspective, the simplest daily habits, including consistent meal timings, cutting back on ultra-processed foods and staying well hydrated, are far from small. Done consistently, they are genuinely life-changing,” concludes Malhotra.

https://indianexpress.com/article/lifestyle/health/diabetes-timeline-first-10-years-after-diagnosis-body-effects-10691052/

How might diabetes lead to Alzheimer’s? Study suggests liver is key

From asbmb.org

Researchers trace a path from the gut to the brain and say managing diabetes could help to prevent dementia 

New research conducted in mice offers insights into what’s going on at the molecular level that could cause people with diabetes to develop Alzheimer’s disease.

The study adds to a growing body of research on the links between Type 2 diabetes and Alzheimer’s disease, which some scientists have called “Type 3 diabetes.” The findings suggest that it should be possible to reduce the risk of Alzheimer’s by keeping diabetes well controlled or avoiding it in the first place, according to researchers.

Narendra Kumar, an associate professor at Texas A&M University in College Station, led the study.

“We think that diabetes and Alzheimer’s disease are strongly linked,” Kumar said, “and by taking preventative or amelioration measures for diabetes, we can prevent or at least significantly slow down the progression of the symptoms of dementia in Alzheimer’s disease.”

Kumar will present the new research at Discover BMB, the annual meeting of the American Society for Biochemistry and Molecular Biology, which is being held March 23–26 in San Antonio.

Diabetes and Alzheimer’s are two of the fastest-growing health concerns worldwide. Diabetes alters the body’s ability to turn food into energy and affects an estimated 1 in 10 U.S. adults. Alzheimer’s, a form of dementia that causes progressive decline in memory and thinking skills, is among the top 10 leading causes of death in the United States.

Diet is known to influence the development of diabetes as well as the severity of its health impacts. To find out how diet could influence the development of Alzheimer’s in people with diabetes, the researchers traced how a particular protein in the gut influences the brain.

They found that a high-fat diet suppresses the expression of the protein, called Jak3, and that mice without this protein experienced a cascade of inflammation starting with the intestine, moving through the liver and on to the brain. Ultimately, the mice showed signs of Alzheimer’s-like symptoms in the brain, including an overexpressed mouse beta-amyloid and hyperphosphorylated tau, as well as evidence of cognitive impairment.

“Liver being the metaboliser for everything we eat, we think that the path from gut to the brain goes through liver,” Kumar said.

His lab has been studying functions of Jak3 for a long time, he added, and they now know that the impact of food on the changes in the expression of Jak3 leads to leaky gut. This in turn results in low-grade chronic inflammation, diabetes, decreased ability of the brain to clear its toxic substances and dementia-like symptoms seen in Alzheimer’s disease.

The good news, according to Kumar, is that it may be possible to stop this inflammatory pathway by eating a healthy diet and getting blood sugar under control as early as possible. In particular, people with prediabetes — which includes an estimated 98 million U.S. adults — could benefit from adopting lifestyle changes to reverse prediabetes, prevent the progression to Type 2 diabetes and potentially reduce the risk of Alzheimer’s.

https://www.asbmb.org/asbmb-today/science/032324/how-might-diabetes-lead-to-alzheimers

World Liver Day 2022: How to protect your liver when you have diabetes

From hindustantimes.com

World Liver Day 2022: If you have diabetes, you must take care of your liver as not paying attention to this crucial organ could cause great damage 

World Liver Day 2022: Diabetes is a silent killer and damages more body functions than is apparent. If you have diabetes, your liver needs utmost care as not paying attention to this crucial organ could lead to a condition called non-alcoholic fatty liver disease (NAFLD) which in turn may cause liver cirrhosis or scarring of the liver. Eating a well-balanced diet with lots of fresh fruits and vegetables at regular intervals and staying active could play a key role in protecting your liver. 

Diabetes is the second cause of liver failure and transplantation in India. Type 2 diabetes is a chronic condition that impacts the way one’s body metabolizes sugar. It happens when the body becomes resistant to insulin. This can invite complications along with liver disease. Hence, one will not be able to do his/her daily activities with ease.

"Diabetes and obesity will not only lead to non-alcoholic fatty liver disease (NAFLD) wherein excess fat builds up in the liver but also, a more severe form of NAFLD is known as non-alcoholic steatohepatitis (NASH). Here, the liver fat triggers inflammation that creates scar tissue causing cirrhosis and end-stage liver disease over a period of time. Hence, one will need a liver transplant," says Dr. Roy Patankar, Gastroenterologist and Director of Zen Multispecialty Hospital, Chembur, Mumbai.

World Liver Day 2022: Diabetes is the second cause of liver failure and transplantation in India.(Unsplash)

There are no symptoms of liver disease until it's too late hence making it hard to diagnose and treat the ailment early. This is the reason why majority of people with diabetes are unware of liver disease despite inflammation and even scarring. Liver cancer and liver failure are rampant in those having diabetes making it all the more important to monitor this disease.

Having liver disease can also trigger diabetes and go on to worsen the liver functioning.

"Your risk of having metabolic syndrome X - including heart disease, stroke, type 2 diabetes, high blood pressure, insulin resistance, obesity, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels - is higher if you've ever had non-alcoholic fatty liver disease," says Dr Patankar.

How to take care of your liver when you have diabetes

* Manage your blood sugar levels by eating nutritious food and avoiding junk, processed sugary and canned food.

* Limit the intake of colas, sodas, fruit juices, sweets, bakery items, and candies.

* Eat at regular intervals in the quantity recommended by the expert.

* Whole grains, fresh fruits, and vegetables should be a part of your daily diet, exercise every day for about half an hour.

* You can do activities such as swimming, cycling, yoga, gymming, aerobics, running or jogging.

* Cut down on sodium and caffeine to keep high blood pressure in check. Say NO to smoking and alcohol. Get yourself screened as suggested by the doctor to catch the liver disease.

https://www.hindustantimes.com/lifestyle/health/world-liver-day-2022-how-to-protect-your-liver-when-you-have-diabetes-101650187495793.html

Simple Type-2 Diabetes Treatment With Low Calorie Diet is So Effective

From goodnewsnetwork.org

A “breakthrough” treatment plan for type-2 diabetes has the British National Health Service (NHS) bustling as they position themselves to adopt a new standard of treatment.
The course of treatment consists of a liquid diet of 800 calories to be taken as a soup or shake daily for a set amount of months depending on the time since the patient developed type-2 diabetes.

The breakthrough research arose out of Newcastle University which seems to have stuck a pin in many of our assumptions about type-2 diabetes—as well as proven almost beyond a shadow of a doubt that type-2 diabetes is actually reversible, especially in newer patients.

The treatment is basically a prescription for a reduction in calorie intake—a potential intervention that has shown incredible results for many different conditions.

The Diabetes Remission Clinical Trial, (DiRECT) recently published these findings as a means of demonstrating the massive potential of DiRECT as a general treatment plan.
One-third of all people taking part in the trial were free of diabetes at 2 years. Around three quarters of everyone who was in remission at 1 year stayed in remission at 2 years. Furthermore, the group who embarked on rapid weight loss had fewer serious medical problems in the second year of DiRECT.

The Nature of the Beast

Official statistics from the NHS place the number of Brits with type-2 diabetes at 4 million, and rising. Meanwhile, in the United States, the CDC reports that 1 in 10 Americans—roughly 30 million people—have diabetes, 90% of which is type-2. Many people also go undiagnosed for years.

Recent studies carried out by Professors Mike Lean and Roy Taylor of Newcastle University showed that type-2 diabetes is triggered by fat spills. These fat spills, which came from the liver, travelled to the nearby pancreas where it wreaked havoc in the efficiency of the organ to produce insulin.
Insulin is needed to command your cells to absorb excess carbohydrates circulating in your body after a carb or sugar-dense meal.

“The liver fat, astonishingly high in type 2 diabetes, falls to normal,” explains Dr. Taylor in an interview with Medscape. “The pancreas fat comes down gradually, gradually, and the pancreas recovers gradually, gradually. And that’s amazing because we always thought that the pancreas had to go downhill inevitably in type 2 diabetes.”

In April 2020, the NHS will begin trials with a liquid diet as per the DiRECT research with 5,000 participants helping to test whether the program can benefit the public. If the trials are successful, the breakthrough diet will become the new standard of care in a remarkably rapid frame of time for the chronic ailment that’s been causing amputations, blindness, and heart complications for decades.

The widely-taken drug Metformin has been the standard of care for the treatment of diabetes in France since 1957 and in Canada since 1972. Illustrative of how long it can take to approve a treatment in the U.S., Metformin didn’t receive approval by the FDA until 1994, even though 5.8 million Americans were diagnosed with diabetes in 1980.

Like all professional men and women of science, Taylor feels more research is needed before the liquid diet intervention is widely prescribed.

“We need to follow up this group,” said Taylor. “We follow them up for a total of 2 years in the proper randomized controlled trial.”
“We have funding to follow up the intervention group participants for a total of 3 years. And we’ve applied for further funding because we need to see what happens to these people as time goes on.”

But, he admits it is “heart-warming” hearing all the stories about remissions. “It’s all about the individual and all about helping people back to this state of relative health and happiness. And that does seem to be happening in quite large numbers of people who are able to do it.”

https://www.goodnewsnetwork.org/simple-new-type-2-diabetes-treatment-may-be-new-standard-of-care/

Study reveals what causes type 2 diabetes and how to reverse it

From medicalnewstoday.com

As the incidence of diabetes continues to increase globally, the fight against this chronic condition continues. New research explains not only what triggers type 2 diabetes but also how to reverse the condition. The findings also shed light on what leads to remission after reversal for some people.

Between 1980 and 2014, the number of people living with diabetes across the world increased from about 108 million to 422 million.
As many as 90% of these individuals have type 2 diabetes.

Pharmacological interventions have done little to stop what some have referred to as the diabetes pandemic.

Lifestyle interventions, however, may succeed where other approaches have failed.
A couple of years ago, Medical News Today reported on the first results of a clinical trial, which showed that intensive weight loss programs could help people with type 2 diabetes achieve remission without taking any medication.

The trial was called the Diabetes Remission Clinical Trial (DiRECT), and one of its co-leaders was Prof. Roy Taylor from Newcastle University in the United Kingdom.

But how does this remission occur, and can it last in the long term? Why do some people achieve lasting remission while for others, the condition returns?

Prof. Taylor set out with his team to answer these questions, using data from the DiRECT trial and applying cutting-edge imaging and blood monitoring techniques.

The researchers published their findings in the journal Cell Metabolism.

Testing the 'twin cycle hypothesis'

The study aimed to test — and confirm — the so-called twin cycle hypothesis, which Prof. Taylor and team put forth more than a decade ago.
The theory proposed that type 2 diabetes results from the accumulation of fat in the liver, which induces insulin resistance and increases blood sugar production.

These effects, in turn, increase plasma insulin levels, precipitating "a self-reinforcing cycle" in which insulin stimulates fat production.

These increased levels of liver fat cause the lipids to overspill into several tissues, including the pancreas.
Beta-cells, which are responsible for creating insulin, are located in the pancreas. "Long-term exposure to saturated fatty acids is harmful to [beta]-cells," write the authors.

The researchers wanted to "describe the pathophysiologic processes underlying the recurrence of type 2 diabetes in the group that initially achieved remission but then relapsed back to diabetes."
To this end, the researchers quantified intra-organ and abdominal fat using cutting-edge MRI scans at 12 and 24 months. They looked at pancreatic and liver fat, specifically.

The analysis included measurements of glucose, HbA1c, high-density lipoprotein (HDL) cholesterol, and triglycerides. The team also analysed fatty acids, insulin secretion, and beta-cell function.

When liver fat 'clogs up' the pancreas

The study revealed that the majority of the trial participants maintained remission over the 2 years but that this was only possible if liver triglycerides and fat in the pancreas remained low.
Specifically, almost 9 out of 10 participants who managed to lose 15 kilograms or more in the DiRECT trial reversed their condition.

After 2 years, more than one-third of these individuals had been free of diabetes and the need for diabetes medication for at least 24 months.

A small group, however, experienced relapse, which was associated with a return to high liver triglycerides and high intra-pancreatic fat levels.

Prof. Taylor explains: "We saw that when a person accumulates too much fat, which should be stored under the skin, then it has to go elsewhere in the body. The amount that can be stored under the skin varies from person to person, indicating a 'personal fat threshold' above which fat can cause mischief."

"When fat cannot be safely stored under the skin, it is then stored inside the liver and overspills to the rest of the body, including the pancreas. This 'clogs up' the pancreas, switching off the genes [that] direct how insulin should effectively be produced, and this causes type 2 diabetes."

Prof. Roy Taylor

'Diet and persistence' can reverse diabetes

"This means we can now see type 2 diabetes as a simple condition where the individual has accumulated more fat than they can cope with," continues the author, stressing the hopeful implications of this finding.

"Importantly, this means that through diet and persistence, patients are able to lose the fat and potentially reverse their diabetes. The sooner this is done after diagnosis, the more likely it is that remission can be achieved."

"For the first time," conclude Prof. Taylor and team in their paper, "we are able to report the underlying physiologic changes during a full cycle of disease reversal and re-emergence."
In the U.K., the National Health Service (NHS) will roll out a program that will test the weight loss therapy in thousands of people living with type 2 diabetes.

https://www.medicalnewstoday.com/articles/327390.php#5