Laura Saslow, an associate professor at the University of Michigan School of Nursing with over a decade of research on dietary impacts on type 2 diabetes, discusses findings from her recent study.
What is type 2 diabetes?
Type 2 diabetes results from insulin resistance in cells, hindering sugar absorption, and inadequate insulin production by the pancreas, leading to sustained high blood glucose levels. This condition increases risks of vascular damage and other complications.
What were the main findings of your trial on a very low-calorie diet for diabetes remission?
In the Diabetes Remission Clinical Trial, approximately 300 participants in the UK opted for either a control group or a very low-calorie liquid diet (about 850 calories daily) for three months. The intervention group ceased diabetes and high blood pressure medications initially, reintroducing regular food gradually while maintaining weight loss support. After one year, 46% achieved remission, with 36% maintaining remission after two years, compared to 2-4% in the control group.
What were the main findings of the Indiana University trial on a very low-carbohydrate ketogenic diet for diabetes reversal or remission?
Led by Sarah Hallberg, the Indiana University trial involved around 350 participants choosing standard diabetes care or a very low-carbohydrate ketogenic diet (keto diet). This diet limits carbohydrate intake to induce ketosis, shifting the body’s energy source from glucose to fats. Results showed significant reductions in medication use, with 60% of insulin users discontinuing it. After one year, 47% achieved remission or reversal, and 38% maintained it after two years, compared to 7-10% in the control group.
Are there any new dietary approaches showing promise for diabetes remission?
Continuous glucose monitoring combined with dietary advice demonstrated promise, with 63% achieving remission in one Indian study after a year, versus none in the control group. The approach focused on increased vegetable and protein intake, reducing average carbohydrate consumption to about 150 grams daily.
Which diets or interventions are less effective for diabetes remission?
Low-calorie, low-fat diets and Mediterranean diets showed lower remission rates. For instance, the Look AHEAD trial reported an 11% remission rate with a low-calorie, low-fat diet after one year, while Mediterranean diet studies showed 14%. Vegan, vegetarian, and DASH diets lack robust evidence for type 2 diabetes remission.
How common is type 2 diabetes in the U.S.?
Approximately 15% of U.S. adults have diabetes, predominantly type 2, with one-third having prediabetes. This condition accounts for substantial healthcare spending annually.
What do ‘remission’ and ‘reversal’ mean for people with type 2 diabetes?
Remission indicates blood sugar levels below diabetic range for at least three months without diabetes medication, while reversal involves maintaining these levels with or without metformin. Both are rare occurrences.
What dietary studies did you review?
Saslow reviewed all relevant clinical trials involving at least 50 participants per group tracked for over a year.
Where can people find resources about eating plans for type 2 diabetes?
Resources include the University of Michigan’s programs for very low-calorie and ketogenic diets, alongside online platforms like Diet Doctor and Virta Health. Cookbooks such as ‘The Wholesome Yum Easy Keto Cookbook’ and ‘The Everyday Ketogenic Kitchen’ offer practical guidance.
For further information, Saslow’s review of clinical trial evidence on eating patterns for type 2 diabetes is available online this year as part of the Sarah Hallberg Legacy Course, honoring the late physician’s impactful research on diabetes reversal.