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Can diet reverse diabetes?

Anecdotes of people claiming to have reduced or gone off diabetes medication altogether after cutting out carbohydrates have seen fad diets cash in on claims of “reversing diabetes”.

Can cutting out the carbs reverse type 2 diabetes? Experts say a healthy diet and lifestyle are the best way to manage the condition that cannot be cured.

But does it really work, and can a diet be the answer to the country’s diabetes problem?

Today marks World Diabetes Day. There are more than 3.5 million adults with diabetes in South Africa, and about half are undiagnosed, according to Prof Larry Distiller, founder of the Centre for Diabetes and Endocrinology (CDE) in Johannesburg.

Diabetes occurs when a person’s body cannot produce enough insulin or use it   effectively. Insulin is produced in the pancreas and enables blood sugar to enter cells where it is used for energy. Without enough insulin, a person’s blood sugar remains so high that it becomes harmful.

About 90 percent of South Africans with diabetes have type 2 diabetes, a form of the disease that develops later in life and is associated with an unhealthy lifestyle, according to the CDE. Risk factors include being overweight, poor diet, physical inactivity and stress.

About ten percent of South Africans suffer from type 1 diabetes, a form of the disease that is not linked to lifestyle and requires daily monitoring and insulin injections.

Diet is an integral part of type 2 diabetes management. People with diabetes should avoid sugary foods and eat foods low on the glucose index (GI). Low GI foods gradually release glucose – a form of sugar – into the blood to avoid sudden spikes or drops in sugar levels, a common problem in people with diabetes who cannot process large amounts of glucose effectively.

Carbohydrates become glucose in the body. Fad diet followers are now claiming that by cutting carbohydrates like bread, starchy vegetables and legumes such as lentils from their diets, that they are able to “reverse” their diabetes.

The experts weigh in

But what do diabetes experts have to say?

“In type 2 diabetes, we do see that once lifestyle changes have been made & weight loss achieved, then blood glucose levels return to normal in some”

Razana Allie with the Diabetes Education Society of South Africa warns that although diabetes can be successfully managed, it cannot be cured.

“In type 2 diabetes, we do see that once lifestyle changes have been made and weight loss achieved, then blood glucose levels return to normal in some people,” said Allie, who added that lifestyle changes and medication are the best, long-term solutions to manage type 2 diabetes.

“As soon as the person gains weight, their blood glucose levels start rising again and for some the effect of the additional weight is so dramatic that they have to take more medication than before,” she said.

Three recent international studies have looked at whether diabetes can effectively be managed through lifestyle changes. Two studies showed that lifestyle changes like increased exercise, better diet and weight loss improved blood sugar control. In some cases, these changes also allowed patients to delay starting treatment, but authors stressed that complete remission to the point where no medication is needed is rare.

A third 2013 UK University of Newcastle study found that extreme, rapid weight loss in people who had been living with diabetes for less than four years led their insulin production to return to normal.

University of Newcastle researchers argued that weight loss, rather than the type of diet used to lose weight, was responsible for insulin levels returning to normal.

“Any pattern of eating which brings about substantial weight loss over a period of time will be effective. Different approaches suit different individuals best,” wrote the lead researcher, University of Newcastle Professor Roy Taylor.

According to Allie, people with diabetes should chose low GI, complex carbohydrates over highly processed carbohydrates such like white bread or cake, but cutting out all carbohydrates is not a solution.

“Our unemployment rate is high and many old people don’t have enough money to afford three balanced meals a day,” she told Health-e News. “For many people, carbohydrates, like bread, pap and rice, are the only nutrients they receive.”

“Eliminating carbohydrates completely will result in starvation for a large number of South Africans,” said Allie, who added that high fibre beans and pulses offer a healthy and affordable option. – Health-e News.

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