Weight Loss and Diabetes

Excess body weight is a key risk factor for Pre Diabetes and Type 2 Diabetes. Around 60% of the Australian adult population are overweight or obese and this is making a significant contribution to the numbers being diagnosed with Pre Diabetes and Type 2 Diabetes (AIHW, 2008).

At the end of March 2016, there were 1,036,819 people registered with Type 2 Diabetes on the National Diabetes Services Scheme. Of these, 96% were aged 40 years or over. The scheme estimates 25% of Australian adults aged 25 years and over have either Pre Diabetes (impaired fasting glucose or impaired glucose tolerance) or Type 2 Diabetes (Diabetes Australia, 2016).

This Diabesity (Diabetes and Obesity) epidemic has led to the necessity to identify preventative strategies designed to achieve better population outcomes.

This is because management of Pre Diabetes prevents progression to Type 2 Diabetes. If you have been diagnosed with Pre Diabetes, reducing weight is one of the most important things you can do to reverse the condition and prevent the onset of Type 2 Diabetes. If you have already been diagnosed, there is potential to achieve Type 2 Diabetes remission with sufficient weight loss.

The PREVIEW (Prevention of Diabetes through lifestyle Intervention and population studies in Europe and around the World) trial has looked at how specific lifestyle patterns can help prevent Type 2 Diabetes.  Program partners from Europe, Canada, Australia and New Zealand have worked collaboratively in a bid to address the global epidemic worldwide. Early results across 2000 participants showed compliance with an 800kCal total dietary replacement diet for 8 weeks resulted in 10.8% weight reduction and reversal of Pre Diabetes. A six month follow up has shown this result can be maintained with weight maintenance on a far less restrictive dietary regimen. The full results of the PREVIEW study are due to be published late in 2016 (PREVIEW, 2016).

There is some positive news for those already diagnosed with Type 2 Diabetes. Recent research out of the University of Newcastle has shown that acute energy restriction can put Type 2 Diabetes into remission (Lim et al., 2011 and Stevens and Taylor, 2015). Participants who adhered to a medically supervised 800kCal diet for 8 weeks and lost on average 15% of their initial weight, saw their blood glucose return to normal levels. So important are these initial results, Diabetes UK has awarded its largest ever single research grant to find out if a less restrictive but still intensive weight management plan is an effective primary care treatment to help people achieve enduring Type 2 Diabetes remission. The results of the Diabetes Remission Clinical Trial (DiRECT) are due in 2018 (Leslie et al., 2016).

Weight loss combined with Pre Diabetes reversal or Type 2 Diabetes Remission and not just weight loss per se seems to be a strong motivator for health motivated individuals to achieve and maintain weight loss (Stevens et al., 2013). While this approach may not be suitable for all, given the size of “Diabesity” issue, it can’t be ignored as a treatment option that will be achievable for some.