DR MICHAEL MOSLEY: How the 5:2 diet reversed my Type 2 diabetes... and now a life-changing new eating plan could do the same for you

From dailymail.co.uk/health

We often read about newly discovered ‘wonder’ drugs or ‘game-changing’ health technology. But in truth, few make an impact on the world.

Actual scientific breakthroughs are incredibly rare, so I am privileged to have witnessed one first-hand, which I am sure will prove to be revolutionary.

I am convinced that research by my friend Professor Roy Taylor and his colleagues from Newcastle University will change the way we treat the greatest health problem of our time – type 2 diabetes. These pioneering scientists have shown that this deadly condition, which affects about four million Britons, can be put into remission with a rapid weight-loss diet.

Now, in his new book, Life Without Diabetes, Prof Taylor reveals the science behind his discoveries and how you can do the same, at home.

Before Prof Taylor’s discovery, it was thought that this pressing health problem – which affects twice as many people as it did 20 years ago – could not be reversed. It was a lifelong affliction and inevitably progressive. Complications include an increased risk of heart disease, dementia, amputation, blindness and kidney failure. People would be advised to take tablets and hope for the best. But thanks to a ground-breaking study, called DiRECT, carried out by Prof Taylor and his colleague Professor Mike Lean at the University of Glasgow, we now know this needn’t be the case.

I was so impressed by their research that I used it as inspiration, and adapted it slightly for my Eight-Week Blood Sugar Diet which involves eating 800 calories each day for 12 weeks. I am pleased to say it has so far helped thousands of readers send their diabetes into remission.

This approach is predicted to spark a seismic change in how doctors treat the condition, saving the NHS millions of pounds.

                  Actual scientific breakthroughs are incredibly rare, so I am privileged to                                           have witnessed one first-hand, which I am sure will prove to be revolutionary

A recent study revealed that an 800-calorie diet could slash the annual cost of treatment for type 2 diabetes. Currently, treating each patient costs about £2,800 every year, which adds up to about ten per cent of the annual NHS budget. But diet interventions, such as the one pioneered by Prof Taylor, cost just over £1,000 per patient.

I’m keen to explain how I came to know Prof Taylor – both personally and professionally – and show you how, if you have raised blood sugars – and perhaps are on the verge of diabetes – you can bring them back down to normal with a rapid weight loss diet. I should know – I’ve been there…

HOW I GOT STARTED... WITH INTERMITTENT FASTING 

My first meeting with Professor Taylor, in June 2014, followed my own battle with type 2 diabetes.

As I have written previously in this newspaper, I was diagnosed with the condition eight years ago, following a routine blood test.

My doctor said there was nothing that could be done apart from taking medication. I would start on the widely prescribed metformin, but there was a 50-50 chance that within a decade I would be forced to inject myself with insulin. Naturally, I was shocked.

My father had developed type 2 diabetes in his late 50s, and despite being on medication, he died of complications of that disease, including heart failure. I didn’t want to follow his example, so I looked elsewhere for answers.

I soon came across research showing the benefits of something, which was little-known at the time, called intermittent fasting. It involved restricting calories for a portion of the week, and led to my discovery of a new approach to weight loss which I called the 5:2. For those of you who aren’t familiar with it, it involves cutting calories for just two days each week.

Over the course of two months, I lost nearly a stone and a half – and my blood sugar levels returned to normal, where they have stayed ever since. This proved to be the inspiration for my first international bestseller, The Fast Diet, with journalist Mimi Spencer.

Despite this success, I still didn’t fully understand the science behind my health transformation. Then I read about the work of Prof Taylor. It made a lot of sense, so I took a train to his research centre at Newcastle University to find out more.

He explained that the reason I had developed the condition in the first place was because I had, over the years, accumulated too much fat around my gut. This fat had begun to clog up my liver and pancreas, stopping them working properly. These organs are vitally important for regulating blood sugar levels. In type 2 diabetes, the body’s system of regulating blood sugar goes awry.

Prof Taylor, who is an honorary endocrinology consultant at the Newcastle Hospitals NHS Trust, also introduced me to something he called ‘the personal fat threshold’. This is partly why some people can become hugely overweight without developing diabetes, while others can be a healthy weight and still become diabetic.

Your personal fat threshold is determined largely by your genes – having a close relative with diabetes, like I did, puts you at much greater risk.

But there was good news. He had conducted studies which found that most people could return their blood sugars to non-diabetic levels by losing just one gram of fat from around their pancreas. To do that, they needed to lose roughly ten per cent of their body weight. Then Prof Taylor told me about an upcoming trial called DiRECT – which would prove to be hugely important.

DRUG-FREE WAY TO FIGHT THE DISEASE 

Along with Mike Lean, professor of human nutrition at Glasgow Royal Infirmary, and supported by a multi-million-pound grant from charity Diabetes UK, Prof Taylor recruited nearly 300 type 2 diabetes patients.

Half were asked to follow a rapid weight-loss approach to treatment, and the other half allocated standard NHS care. Patients in the weight-loss group were given a strict 800-calorie- a-day eating plan for up to 12 weeks, made up of three meal-replacement shakes.

The initial findings, published at the end of 2018, were sensational. Those eating 800 calories a day for 12 weeks lost an average of one-and-a-half stone – and the weight stayed off for more than a year.

In comparison, the control group lost an average of just over 2 lb. What’s more, half of the 800-calorie patients put their diabetes into remission. Their blood sugar levels went back to normal, without medication. Only four per cent in the control group managed to achieve this.

A follow-up study, was published last year and, impressively, the 800-calorie group had managed to keep most of the weight off.

Despite being on much less medication, they also continued to have lower blood sugar, cholesterol and blood pressure levels than the control group.

In the group getting standard NHS care, two had suffered strokes, one had an amputation, and another sadly died from complications of the disease.

Other research has trialled different versions, for example swapping some of the calories in shakes for a small portion of vegetables to increase bowel-friendly fibre.

The results of the DiRECT trial were so promising, that NHS chiefs have announced that more than 5,000 patients are being offered a rapid weight-loss programme, starting in April.

             We used to be told: Take pills and hope for the best. One man has changed all that

As Prof Lean said to me: ‘For years we’ve been telling type 2 diabetes patients to take the pills and not worry too much.

‘It is time to tell them that this is a serious disease with nasty complications, particularly if you develop it in your 40s or 50s. But the good news is that with the right help, many people can now get shot of it.’

HERE’S HOW YOU CAN REVERSE IT AT HOME

Another bit of good news is you don’t have to be part of a medical trial to see these phenomenal results – thousands of people have had great success sticking to this sort of programme.

Of course if you’re doing it at home, the circumstances will be different. For instance, in the DiRECT study, patients were asked to consume special meal-replacement shakes. These shakes can be very helpful, particularly when starting out. But you can also do it with real, solid food.

A small study conducted by researchers at Oxford University randomly allocated 33 overweight patients with type 2 diabetes to an 800-calorie-a-day diet, or standard care.

Patients were given advice from health professionals – including ideas for recipes – and prepared meals for themselves at home.

After three months, those on the 800-calorie diet lost an average of one-and-a-half stone and saw big drops in their blood sugar levels.

As in the DiRECT study, many of them were able to come off their medication.

There’s plenty more recipes that stick within the 800 daily calorie limit on my website, thefast800.com.

But what if a rapid weight- loss diet isn’t for you? Any diet that involves losing enough weight to unclog your pancreas will almost certainly help. ‘Enough’ usually means ten per cent of your body weight – or at least 22 lb if you are overweight.

One tried and tested method of losing weight at a slower pace is via the 5:2 diet, which is the way I did it.

For five days of the week, eat a healthy, balanced diet, and steer clear of sweet, fatty stuffs such as chocolate and crisps. Then, for two days, stick to 800 calories.

In a recent Australian study involving 137 patients with type 2 diabetes, those allocated to a 5:2 diet managed to sustain an average weight loss of roughly a stone over the course of a year, leading to big improvements in blood sugar levels. The participants who were the most diligent kept off an average of 1st 9 lb.

In Prof Taylor’s three-stage plan in You magazine, he recommends sticking to three, small and healthy meals daily for long-term weight maintenance, and 100 calories of vegetables for added fibre. The specially crafted recipes include imaginative things you can do with vegetables, which will help the process.

These days, he recommends a total limit of a slightly stricter 700 calories, to allow room for the odd cup of tea – which we know Britons struggle to live without.

If you can manage this, great. But many struggle with this, knowing that they’ll be tempted by the occasional weekend takeaway or chocolate bar.

So some people find a 5:2 eating pattern easier to stick to, as it leaves space for the odd treat. Just make sure it really is occasional, of course.

Life Without Diabetes, by Professor Roy Taylor, is published by Short Books, priced £9.99.

https://www.dailymail.co.uk/health/article-7876349/DR-MICHAEL-MOSLEY-5-2-diet-reversed-diabetes.html

Can People with Diabetes Eat Mango?

From healthline.com
By Ansley Hill, RD, LD

Often referred to as “the king of fruits,” mango (Mangifera indica) is one of the most beloved tropical fruits in the world. It’s prized for its bright yellow flesh and unique, sweet flavour.

This stone fruit, or drupe, has been primarily cultivated in tropical regions of Asia, Africa, and Central America, but it’s now grown across the globe.
Given that mangoes contain natural sugar, many people wonder whether they’re appropriate for people with diabetes.

This article explains whether people with diabetes can safely include mango in their diets.

Mango is very nutritious

Mangoes are loaded with a variety of essential vitamins and minerals, making them a nutritious addition to almost any diet — including those focused on improving blood sugar control.
One cup (165 grams) of sliced mango offers the following nutrients:

• Calories: 99
• Protein: 1.4 grams
• Fat: 0.6 grams
• Carbs: 25 grams
• Sugars: 22.5 grams
• Fibre: 2.6 grams
• Vitamin C: 67% of the Daily Value (DV)
• Copper: 20% of the DV
• Folate: 18% of the DV
• Vitamin A: 10% of the DV
• Vitamin E: 10% of the DV
• Potassium: 6% of the DV

This fruit also boasts small quantities of several other important minerals, including magnesium, calcium, phosphorus, iron, and zinc.

Has a low impact on blood sugar

Over 90% of the calories in mango come from sugar, which is why it may contribute to increased blood sugar in people with diabetes.
Yet, this fruit also contains fibre and various antioxidants, both of which play a role in minimizing its overall blood sugar impact.

While the fibre slows the rate at which your body absorbs the sugar into your blood stream, its antioxidant content helps reduce any stress response associated with rising blood sugar levels.
This makes it easier for your body to manage the influx of carbs and stabilize blood sugar levels.

Glycaemic index of mango

The glycaemic index (GI) is a tool used to rank foods according to their effects on blood sugar. On its 0–100 scale, 0 represents no effect and 100 represents the anticipated impact of ingesting pure sugar.

Any food that ranks under 55 is considered low on this scale and may be a better choice for people with diabetes.

The GI of mango is 51, which technically classifies it as a low GI food.

Still, you should keep in mind that people’s physiological responses to food vary. Thus, while mango can certainly be considered a healthy carb choice, it’s important to evaluate how you respond to it personally to determine how much you should include in your diet.

How to make mango more diabetes-friendly

If you have diabetes and want to include mango in your diet, you can use several strategies to reduce the likelihood that it will increase your blood sugar levels.

Portion control

The best way to minimize this fruit’s blood sugar effects is to avoid eating too much at one time.

Carbs from any food, including mango, may increase your blood sugar levels — but that doesn’t mean that you should exclude it from your diet.

A single serving of carbs from any food is considered around 15 grams. As 1/2 cup (82.5 grams) of sliced mango provides about 12.5 grams of carbs, this portion is just under one serving of carbs.

If you have diabetes, start with 1/2 cup (82.5 grams) to see how your blood sugar responds. From there, you can adjust your portion sizes and frequency until you find the amount that works best for you.

Add a source of protein

Much like fibre, protein can help minimize blood sugar spikes when eaten alongside high carb foods like mango.

Mango naturally contains fibre but isn’t particularly high in protein.

Therefore, adding a protein source may result in a lower rise in blood sugar than if you were to eat the fruit by itself.

For a more balanced meal or snack, try pairing your mango with a boiled egg, piece of cheese, or handful of nuts.

The bottom line

Most of the calories in mango come from sugar, giving this fruit the potential to raise blood sugar levels — a particular concern for people with diabetes.
That said, mango can still be a healthy food choice for people trying to improve blood sugar control.
That’s because it has a low GI and contains fibre and antioxidants that may help minimize blood sugar spikes.

Practicing moderation, monitoring portion sizes, and pairing this tropical fruit with protein-rich foods are simple techniques to improve your blood sugar response if you plan to include mango in your diet.

https://www.healthline.com/nutrition/mango-is-good-for-diabetes#bottom-line

Type 2 diabetes warning: Adding this ingredient to your meals may increase your risk

From express.co.uk

TYPE 2 diabetes is strongly tied to unhealthy lifestyle decisions so making poor choices can heighten your risk of developing the chronic condition. While some dietary decisions are patently risky, others present more hidden dangers, including a mealtime staple.

Type 2 diabetes is a chronic condition in which a person’s pancreas doesn’t produce enough insulin to regulate blood sugar levels. This impaired mechanism may not pose a threat initially, but overtime, unregulated blood sugar levels can hike your risk of developing chronic diseases such as heart disease and stroke. It is therefore important to keep your risk of developing type 2 diabetes at bay and this means cutting back on or completely avoiding unhealthy lifestyle habits.

Certain dietary decisions have been seen to raise the risk of developing type 2 diabetes by causing blood sugar levels to spike.

The worst offenders are foods that rank high on the glycaemic index. The glycaemic index is a value assigned to foods based on how slowly or how quickly those foods cause increases in blood sugar levels.
Foods with a high carbohydrate content pose the greatest threat to blood sugar management because carbohydrate is broken down into glucose relatively quickly and therefore has a more pronounced effect on blood sugar levels than either fat or protein, explains Diabetes.co.uk.

One particular high-carb food that has been shown to heighten your risk of developing type 2 diabetes is white rice.

                  Type 2 diabetes: Regularly eating white rice is associated with an increased risk                                                                                  (Image: Getty Images )

Research published in the journal BMJ suggested that eating white rice regularly - a common practice in Asian countries - may increase risk for developing type 2 diabetes.

To gather their findings, researchers looked at data from four studies: two in Asian countries (China and Japan) and two in Western countries (the U.S. and Australia). All participants were diabetes-free when the study began.

On average, people from Asian countries ate about four servings of white rice daily, whereas individuals in Western countries ate less than five servings a week.
After analysing the data, researchers found that diabetes risk rose by about 10 percent with each increased serving per day of white rice.

Accounting for the association, researcher Qi Sun, M, an instructor in medicine at the Harvard School of Public Health in Boston, suggests that, in addition to the high-carb content of white rice, the popular ingredient also has a low-fibre content and fibre intake has been shown to reduce your risk of developing the chronic disease.

According to Sun, other white, starchy carbohydrates, such as white bread, white pasta, and white potatoes, will also heighten your risk if eaten often enough.
While swapping white carbs for whole grain equivalents may reduce the risk, you do not have to shun rice completely, he said.

How can I increase my fibre intake?

According to Diabetes.co.uk, the surest way to add more fibre to your diet is to eat plenty of vegetables.

“The Department of Health advises us to eat at least five portions of vegetables and fruit each day. Generally speaking, beating rather than meeting the daily target is recommended,” advises the health body.
As the health site explains, if you’re buying starchy foods such as rice, bread or pasta, look for those with higher amounts of fibre per 100g.

“Foods listed as whole grain should usually be good picks but checking the nutritional value per 100g tends to be the most reliable way of ensuring you pick a high fibre option,” it added.

The NHS does advise exercising a degree of caution when upping your fibre intake, however, as it could lead to stomach cramps and bloating in the short term, so it is important to keep hydrated at the same time.

https://www.express.co.uk/life-style/health/1224927/type-2-diabetes-symptoms-diet-white-rice-fibre-lower-blood-sugar

Can you be thin and diabetic?

From gulfnews.com/uae

While weight is a risk factor for the condition, it is just one of many potential causes

The association between a poor diet, sedentary lifestyle and diabetes is well documented. It is misleading, however, to assume that type 1 and type 2 diabetes can only affect those that are overweight.

The condition can be found in people of all shapes and sizes and being too heavy is only one risk factor that can contribute to your likelihood of developing diabetes. Dr Muhammad Hamed Farooqi, Director and Consultant Endocrinologist, Dubai Diabetes Centre, DHA, says both type 1 and type 2 diabetes can affect people at a range of different ages. “Either one of these can occur at any age.

Mostly, type 1 diabetes is seen in younger people while type 2 tends to affect older individuals.

“In the majority of cases, overweight individuals have type 2 diabetes and those with type 1 tend to be on the leaner side, but this is not always the case.”

                                                              Image Credit: iStock

Type 1 vs type 2 diabetes

The two subtypes of the condition have similarities but there are also a number of distinctions, including what causes them. Type 2 diabetes accounts for the majority of cases with type 1 affecting less than 10 per cent of people with the condition. Type 1 diabetes is an autoimmune condition, where the body attacks the cells in the pancreas meaning that people can’t produce insulin. Although there is no cure, patients manage their blood sugar levels by taking insulin.

Type 2 diabetes is where the body is unable to create enough insulin or the insulin being produced doesn’t work properly. While insulin can also be prescribed, people can also control the symptoms through lifestyle modifications such as improved diet and regular exercise. Although there is no cure for type 2 diabetes, it can be prevented or put into remission through lifestyle improvements.

Risk factors

Dr Farooqi says that there are multiple risk factors for type 1 diabetes. “The possible risk factors for type 1 diabetes include a genetic predisposition, geographical location to the equator, and exposure to viruses.

There is also a genetic predisposition to type 2 diabetes, especially if you have a family history of the condition. Ethnicity can also be a risk factor, with South Asian populations more likely to suffer from the condition. Age is also a risk factor, with type 2 diabetes more likely to be diagnosed in those over 25 years old.

Signs and symptoms

What the two subtypes of diabetes share is that the signs and symptoms can be similar. Dr Farooqi says that patients tend to report increased feelings of thirst and appetite. “Patients also report an increased frequency of urination, including needing to get up during the night. People may also complain of fatigue and weakness as well as intermittent blurry vision. Other symptoms can include slower healing of wounds and a tingling, feelings of numbness, pain or a loss of sensation in the hands or feet.”

Dr Farooqi says that dark velvety patches of skin around the neck or other skin folds can also be a sign of diabetes.

Skinny fat

One risk factor for type 2 diabetes is often referred to as skinny fat. It is typified by people with slender bodies and small amounts of visible fat. It is when people are metabolically obese but of an average weight. People affected tend to have higher levels of visceral fat, which is fat that accumulates around the organs, so it isn’t visible.

The stress factor

An additional consideration for why apparently skinny people may develop diabetes is the role of stress. When someone is stressed, their body tends to produce higher levels of the hormone cortisol.

Although cortisol plays a number of different roles, one of its main functions is to raise blood sugar levels during times of stress. In fact, cortisol is capable of raising blood sugar levels in people who are fasting, so people who are following a healthy diet and exercising could also suffer from high blood sugar levels if they are chronically stressed.

While stress can be a cause of diabetes in a minority of cases, obesity is undoubtedly a risk factor for type 2 diabetes and Dr Farooqi says that the symptoms of the condition can be reversed if blood glucose levels are brought under control. “In type 1 diabetes blood sugar control is achieved by using the right kind of insulin in the right amount at the right time,” he says.

“In type 2 diabetes, this is achieved by following a healthy diet and regular exercise, which then leads to a loss of the excess weight. In addition, the correct combination of tablets and injections as required, under the supervision of your doctor, will result in achieving better sugar control.”

https://gulfnews.com/uae/health/can-you-be-thin-and-diabetic-1.1578297775536

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

Five ways to better manage diabetes in the New Year

From news-medical.net/news

While the new year is a great time to reflect, reset and set new goals, making resolutions can also be stressful, especially for people with diabetes. So, this year, try a new approach. Consider what will help you feel good about yourself and enjoy life more, then put it into practice. The health benefits will follow.

As the new year approaches, AADE suggests the following ways to start the year healthy and stick with it:

1. Sign up for a new activity: What's something you've wanted to try but haven't? Maybe it's taking a dance class or joining a walking club. Trying something new can be fun, and change up the dynamic. You'll feel good about challenging yourself and the health benefits won't hurt either.
2. Focus on meditation and mindfulness: Meditation and mindfulness are having a moment and for good reason – they have been shown to help diffuse stress. When you meditate, you focus on a sound, object, your breathing or movement. This increases your awareness of the present moment, which reduces stress and promotes relaxation. Being mindful during meditation is to be aware of your thoughts and feelings without judging them as good or bad. There are plenty of resources for learning how to meditate or be more mindful, from books and classes to apps that guide you through the process and help you quiet your active mind.
3. Make a new habit: Consider what positive change you could make in your life that you'd feel good about. Maybe it's getting to bed a half hour earlier. Or watching less TV. What about eating fruit instead of candy for a snack? Then put a reminder on your calendar and try to stick to it.
4. Go ahead and try a new eating pattern: Instead of berating yourself for what you've been doing wrong, consider a new eating pattern such as a more plant-based diet. As you consider changing up your eating pattern, there are a few important things to keep in mind:
   • Most diets are fine, as long as they are modified to address your personal needs. Before you start any new diet, discuss it with your diabetes care and education specialist, who can help you try different things in a way that's safe and beneficial for you.
   • It's only going to work as long as you can keep it up, so be sure whatever you try is something you are confident you can stick to.
   • Some fads can be unhealthy, especially for people with diabetes, such as cleanses and detoxes, so steer clear of those.
5. Re-evaluate your medication: Schedule an appointment with your healthcare provider to discuss all the medications and supplements you're taking. Maybe some of the doses need readjustment. Perhaps you no longer need some of them, or there is a new medication you that might work better for you.

https://www.news-medical.net/news/20191231/Five-ways-to-better-manage-diabetes-in-the-New-Year.aspx