THE DIABETES REVOLUTION
▪NHS will launch soup and shake diet ▪Regime proven to beat Type 2 illness ▪Adults could be set target weight
THE NHS today launches a dramatic new weapon in the war on diabetes.
The health Service is introducing a low-calorie diet programme which could help patients with type 2 diabetes reverse their condition.
In a recent trial, nearly half the diabetics on a soups-and-shakes diet of no more than 850 calories a day went into remission.
It comes as a new study suggests that everybody has an individual target weight and could avoid getting type 2 diabetes if they stay below it.
Doctors will first prescribe the radical diet to 5,000 adults across england. It could then be implemented nationwide, potentially bringing millions back from long-term diabetes.
About 4 million people in the UK are diabetic, and about 90 per cent are type 2, which is linked to obesity and poor diet. evidence shows those with this type of diabetes are twice as likely to die from coronavirus.
Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity, said: ‘There has never been a more important time for people to lose weight and put their type 2 diabetes into remission.’
The idea that weight loss could reverse many cases of type 2 diabetes is backed by a radical study which concludes that all older people have a weight ‘threshold’.
If they stay below this target, they might not develop the condition, and if those with the
condition lose enough weight to fall under the threshold, they could reverse it. researchers led by the University of Cambridge tracked more than 445,000 people for an average of eight years to judge their risk of diabetes.
They compared the danger of diabetes from each extra unit of body mass index (BMI) to the long-term risk in those whose genetic quirks predisposed them to being overweight. The study found the risk was scarcely different, suggesting it is not the years of being overweight which matter but whether people’s weight tips them past a certain point.
Professor Brian Ference, the study’s lead investigator, said: ‘Soon doctors may be able to give people a target weight threshold which, if they do not cross it, may mean they will not get type 2 diabetes. This is a hopeful message because it suggests that most cases of diabetes can be prevented.’
The diet programme, which aims to reverse rather than prevent diabetes, is aimed at helping people rapidly shed the pounds, and could include options such as chocolate- flavoured skimmed milk and soya protein shakes and chicken and mushroom soups.
To enter the diet scheme, they need to have been diagnosed with type 2 diabetes in the past six years and be overweight with a body mass index (BMI) of 27 or higher. For black, Asian and ethnic minority patients, it is 25.
After being referred by their gP, they will receive a prescription for 12 weeks of soups and shakes, followed by nine months of support to return to normal food and keep the weight off.
It follows the success of the DirECT trial, a joint project between Newcastle and glasgow universities involving almost 300 people with type 2 diabetes.
Half were given standard dietary advice and left to manage their condition, while the rest were put on a strict soups-and-shakes diet of no more than 850 calories a day, aiming to lose 2 stone (15kg).
Nearly half of those on the strict diet went into remission from diabetes, it was reported in 2017. Two years later, more than a third were still free from diabetes and had avoided significant weight gain.
Mike Lean of the University of glasgow, who co-led the DirECT trial with Newcastle professor roy Taylor, said: ‘Every doctor and scientist dreams of doing research which really changes things and really helps people. People with type 2 diabetes have always faced the threat that the condition will cause serious health problems “sooner or later” – coronavirus makes it sooner.
‘More than ever, we need this scheme to go ahead, especially after a lockdown when many people have been eating more and doing more home-baking, making them more overweight.’
oxford University, which trialled a similar soups-and-shakes diet in a study of 278 people two years ago, reported that dieters lost an average of 1st 9lbs (10.7kg).
Paul Aveyard, co-author of that study, said: ‘It is very important that the NHS is making this available instead of just telling people they have diabetes and sticking them on tablets for ever. Instead of treating the complications of obesity, this means we will be treating the causes.’
Diabetes is estimated to cost the NHS £10 billion a year, while almost one in 20 prescriptions written by gPs is for diabetes treatment. An estimated 12.3 million people in the UK are at risk of developing the blood sugar disorder.
The NHS diet scheme beginning today will also provide people with long-term support to increase their exercise levels. Participants will have regular contact with a coach or doctor, virtual one-toone support and a six-month review with their gP.
Bridget Turner, of Diabetes UK, said: ‘People with type 2 diabetes who have put their diabetes into remission frequently tell us how it has changed their lives. We are so pleased to see that others will now have the same opportunity.’
The study on diabetes weight thresholds, presented at the European
Society of Cardiology congress, found more than 80 per cent of morbidly obese people did not develop type 2 diabetes.
The findings suggest doctors could monitor people’s blood sugar over time. If they become ‘pre-diabetic’, with borderline high blood sugar, it could be a sign they have exceeded their weight threshold. They could then try to lose weight to stay below that threshold, which varies with age, and avoid developing full-blown diabetes.
The next step is for researchers to look at how heavy people are when they develop diabetes, alongside their genes. If groups of people share both genetic quirks and the threshold at which they develop diabetes, this could lead to a genetic test to give individuals their target weight. The study authors hope doctors will be able to tell people their target weight in this way by the end of the year.
‘Eating more in lockdown’