Am I being an idiot or was this not already known?
I thought that if you get diabetes from poor diet, fixing the diet and getting to a healthy weight is the long term treatment?
Diabetes T2 is chronically elevated blood glucose, so the fix is therapeutic carbohydrate restriction. The exogenous carbohydrates are the root cause.
Returning to a healthy weight will naturally follow when insulin is once again able to function normally.
I hate it’s even called diabetes.
T1 is an autoimmune condition.
T2 is chronic glucose instability largely from bad diet.
Here is the actual study : https://doi.org/10.2337/diabetes.54.3.603
ITS FROM 2005!!! Why are they just writing about it now? They didn’t have more updated sources or references to talk about? This is just embarrassing for yale
Reversal of nonalcoholic hepatic steatosis, hepatic insulin resistance, and hyperglycemia by moderate weight reduction in patients with type 2 diabetes
To examine the mechanism by which moderate weight reduction improves basal and insulin-stimulated rates of glucose metabolism in patients with type 2 diabetes, we used (1)H magnetic resonance spectroscopy to assess intrahepatic lipid (IHL) and intramyocellular lipid (IMCL) content in conjunction with hyperinsulinemic-euglycemic clamps using [6,6-(2)H(2)]glucose to assess rates of glucose production and insulin-stimulated peripheral glucose uptake. Eight obese patients with type 2 diabetes were studied before and after weight stabilization on a moderately hypocaloric very-low-fat diet (3%). The diabetic patients were markedly insulin resistant in both liver and muscle compared with the lean control subjects. These changes were associated with marked increases in IHL (12.2 +/- 3.4 vs. 0.6 +/- 0.1%; P = 0.02) and IMCL (2.0 +/- 0.3 vs. 1.2 +/- 0.1%; P = 0.02) compared with the control subjects. A weight loss of only approximately 8 kg resulted in normalization of fasting plasma glucose concentrations (8.8 +/- 0.5 vs. 6.4 +/- 0.3 mmol/l; P < 0.0005), rates of basal glucose production (193 +/- 7 vs. 153 +/- 10 mg/min; P < 0.0005), and the percentage suppression of hepatic glucose production during the clamp (29 +/- 22 vs. 99 +/- 3%; P = 0.003). These improvements in basal and insulin-stimulated hepatic glucose metabolism were associated with an 81 +/- 4% reduction in IHL (P = 0.0009) but no significant change in insulin-stimulated peripheral glucose uptake or IMCL (2.0 +/- 0.3 vs. 1.9 +/- 0.3%; P = 0.21). In conclusion, these data support the hypothesis that moderate weight loss normalizes fasting hyperglycemia in patients with poorly controlled type 2 diabetes by mobilizing a relatively small pool of IHL, which reverses hepatic insulin resistance and normalizes rates of basal glucose production, independent of any changes in insulin-stimulated peripheral glucose metabolism.
Notably the study does not demonstrate reversal of type 2 diabetes, it shows a improvement in fasting glucose which isn’t the same thing (they did not measure hba1c after the weight loss… why not?). The studies control group were NOT obese. After 3-12 weeks on the 60% carbs 1200/kcal a day diet (which is really like 30% carbs, because the energy is coming from the obese patients fat stores).
The conclusion that weight loss results in better insulin sensitivity is a bit backwards - how do you lose weight? You have to reduce insulin to access fat stores, which is increasing insulin sensitivity. i.e. There are MANY non-obese type 2 diabetes - the discussion of this study does not address them.
Also, the virta studies demonstrate type-2 diabetes remission at a 50% rate… they really should have talked about that as a reference in the press release to give context. However those studies are from 2024/2025 not 2005 so maybe yale is having a hard time keeping up with the literature.
The same diet that reverses type 2 diabetes also fixes obesity, heart disease and arthritis. Gone are the days of calories in, calories out. Instead we know it is WHAT you eat, not the intake calories. There are exceptions though, almost half of the population handles a high carb very well due to their genes.
