Low-calorie diet eliminates insulin therapy in diabetic obese patients

A diet of 500 calories a day eliminates insulin therapy in obese patients with type 2 diabetes, according to a study presented Nov. 28 at the annual meeting of the Radiological Society of North America (RSNA).

The study also found that a restricted-calorie diet reduces fat around the heart and improves cardiac function.

“It is striking to see how a relatively simple intervention of a very low calorie diet effectively cures type 2 diabetes mellitus,” said Sebastiaan Hammer, MD, PhD, from Leiden University Medical Center in the Netherlands.

The small study examined the long-term effects of weight loss on 15 obese patients with type 2 diabetes. Researchers used cardiac MRI to measure fat around the heart over a 16-week period. They also measured diastolic heart function and changes in body mass index (BMI).

After four months on a 500-calorie daily diet, none of the participants required insulin therapy.

What’s more, the average BMI of participants decreased from 35.3 to 27.5. A person with a BMI of 30 or higher is classified as obese, according to the World Health Organization. A BMI of 25 to 29.99 is overweight or pre-obese. A BMI of 18.50 to 24.99 is normal.

Fat around the heart decreased from an average of 39 to 31 milliliters. The average E/A ratio for diastolic heart function improved from 0.96 to 1.2.

After the initial four-month diet, participants returned to a regular diet. Average BMI had increased to 31.7 at the 14-month check up. Despite this weight gain, fat around the heart only increased slightly to 32 milliliters.

“Our results show that 16 weeks of caloric restriction improved heart function in these patients,” Hammer said. “More importantly, despite regain of weight, these beneficial cardiovascular effects were persistent over the long term.”

Researchers caution that not all patients are suited to a low-calorie diet therapy and should consult their physicians.

The percentage of adults with diabetes taking both pills and insulin increased from 9.1 percent in 1997 to 12.7 percent in 2009, according to the Centers for Disease Control. Nearly 16 percent of all adults with diabetes use insulin only to help manage their disease. Nearly 48 percent take pills only.

Type 2 diabetes occurs when the body does not make enough insulin to keep up with demand or cannot use the insulin it makes. Type 2 diabetes accounts for 90 to 95 percent of all diagnosed cases of diabetes in adults. About 25.8 million Americans live with diabetes.

Sources: Radiological Society of North America, World Health Organization, Centers for Disease Control

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