Can a diet reverse Type 2 diabetes?
Advocates for a range of diets based on radically different philosophies — from Pritikin to Jenny Craig and Keto to DASH — believe it can. And, for once, there’s actual academic research supporting the diet industry’s claims, says Dr. Enza Gucciardi, associate professor at Ryerson’s School of Nutrition.
“There is actually a lot of evidence now to suggest that diet can reverse diabetes,” says Gucciardi. “Control trials coming out have shown that very low-energy diets can actually help people lose weight and go into what we call a remission, which means that glycemic numbers are lower than the cut-off for diabetic levels. If they lose enough weight, some people go back to the prediabetes status.”
A “prediabetic” is somebody with high blood sugar, but not so high that it warrants medical treatment. If the sugar levels tip over into the danger zone, doctors often prescribe medication, be it insulin therapy or prescription drugs, neither of which offers a cure for the disease and only manage the symptoms. Reversing Type 2 diabetes through diet, by contrast, actually offers a potential cure. That, Gucciardi points out, is a major paradigm shift.
There are a few caveats, however. Gucciardi advises that anyone considering this should talk to their doctor first. Also, this does not apply to people with other forms of diabetes — Type 1, gestational or the other manifestations. And it won’t necessarily work for everyone with Type 2 diabetes, either, since early studies indicate that roughly 60 per cent of test subjects responded positively. That’s a pretty great success rate, though.
Imagine what it might represent to public health if 60 per cent of the estimated 2.7 million Type 2 diabetics in Canada could reverse their diabetes, get back to “prediabetic” levels and get off their meds? Imagine the savings for the health care system. Possibly as many as 1.6 million people could live healthier lives, which would be one of the greatest public health success stories of our age, joining ranks with vaccines, antibiotics and the reduction in tobacco use.
What are we waiting for? Between new research exploring the possibility that diabetes is a risk factor for pancreatic cancer, the rising cost of insulin (admittedly more of a problem in the United States than Canada, where provinces put caps on drug prices) and epidemic rates of diabetes, now would seem to be a perfect time to start prescribing a diet treatment plan for both the prevention of and possible reversal of diabetes. Unfortunately, implementing this treatment is harder than it looks, since it involves actually losing weight which, most of us know, is no easy feat.
“So the next wave of research is, ‘How can we do this in practice how and can we do this in the primary care physicians office?'” says Gucciardi. “How can we do this with everyday people because, you know, when you’re in a controlled study, you’re going to have foods delivered to you, but how can we do this for everybody?’ That’s where we are now.”
Unlike research subjects, most people fail at dieting and, for that matter, eating healthier foods to prevent diabetes and other dietary-related diseases — even those who have a pretty good grasp on what a healthy diet looks like. Just because you know what you should eat, doesn’t mean you have the time, energy or resources to eat well consistently.
“Right now, there’s a whole blame-the-victim idea, that leaves it up to individuals to behave in certain ways to have a good lifestyle,” says Gucciardi. “But that can actually be quite costly for people. You have to have the time, you have to have access to healthy food or, if you want to go and exercise, you have to have access to a gym or equipment or a safe environment to actually go out and have a walk.”