Reversing Type 2 Diabetes and ongoing remission

All this work has depended upon a breakthrough in understanding.

We now know that type 2 diabetes is caused by excess fat inside liver and pancreas.

It all started with sudden coming together of research results from Newcastle and elsewhere. The Twin Cycle Hypothesis described how it might be possible to explain the cause of type 2 diabetes in a very simple way. Click here Reversing the twin cycles of Type 2 diabetes to read the description of this once the story could be told of what happened next. The highest scientific award from Diabetes UK – The Banting Lecture – was awarded for this, and this paper described what was said in the lecture, delivered at the Annual Professional Conference of Diabetes UK in 2012.

In 2008, Diabetes UK had given a grant to test the twin Cycle Hypothesis of the cause of type 2 diabetes. Proof of the hypothesis was published in 2011 as the study Counterpoint. The slides you will see on clicking the Counterpoint link show the data both from this, the most important study on what causes type 2 diabetes as well as the following study.

It was clear from that time onwards that type 2 diabetes is caused by too much fat building up within liver, then overspilling to the rest of the body - including the pancreas. This starts up a second vicious cycle inside the pancreas, with the fat actually switching off normal insulin production.

This second study – CounterBalance - showed that once the vicious cycles of type 2 diabetes had been reversed, the remission of diabetes was durable – as long as weight was not regained. Here is the scientific paper, published in 2016 in Diabetes Care: very low calorie diet and 6 months of weight stability in Type 2 diabetes

One of the most important discoveries is that of the Personal Fat Threshold. Type 2 diabetes is not caused by ‘obesity’. Different people have different levels of tolerance of fat within liver and pancreas. But if you have type 2 diabetes, you have crossed your ‘personal fat threshold’. This has been tested in the ReTUNE study which found that weight loss in people of normal or near normal BMI brought about exactly the same changes in liver and pancreas to that in heavier people. At an average threshold of 6.5% weight loss in this group of people with BMI 21-27, 70% went into remission. This was maintained throughout the one-year study on a normal diet but avoiding weight regain.

Your Personal Fat Threshold (PFT) can only be identified by weight loss. If you lose weight and go below your own PFT, type 2 diabetes is likely to disappear - providing that you have not had diabetes for too long. Most people can get back to normal in the first 6 years after diagnosis, but it is never too late to try. But even if remission of diabetes does not happen, less medication will be needed, and your health will improve massively. Importantly, you will also feel better.

‌Watch Professor Taylor's Newcastle University Public Lecture on reversing type 2 diabetes (4th November 2014).

Diabetes REmissions Clinical Trial – understanding why significant weight loss results in remission of Type 2 diabetes is at the heart of DiRECT.

Once we had shown that type 2 diabetes was a simple condition of too much fat inside liver and pancreas, we needed to move on to discover whether this knowledge could be used for routine treatment of the condition. Professor Roy Taylor collaborated with Professor Mike Lean, University of Glasgow to carry out the Diabetes Remission Clinical Trial (known as DiRECT). It showed:

• One third of all people taking part were free of diabetes at 2 years.
• Around three quarters of everyone who were in remission at 1 year stayed in remission at 2 years.
• The group who embarked on rapid weight loss had fewer serious medical problems in the second year of DiRECT.
• At 5 years, those who avoided weight regain continued to be in remission. Even though the whole weight loss group remained over 6kg below their starting weight, the majority did gain some weight. Despite this, the number of serious medical events was halved in the entire weight loss group.

DiRECT results: Direct results at 2 years full paper and the online DiRECT Appendix are now available. 

View details at:

• the DiRECT study protocol
• Taylor et al: Who was studied in DiRECT at Diabetologia (2018)
• Taylor et all: Substantial weight loss can reverse the processes underlying type 2 diabetes at Taylor et al Cell Metabolism 2018‌
• Al-Mrabeh et al: Hepatic Lipoprotein Export and Remission of Human Type 2 Diabetes after Weight Loss (Cell Metabolism, Dec 2019)

Watch Professor Taylor’s interview: Has DiRECT and Type 2 diabetes remission gone mainstream? (Medscape, 8 March 2019) 

Media coverage and press releases:

• Muscle Memoirs Podcast - Understanding and reversing Type 2 Diabetes (February 2021)
• Primary care weight management leads to sustained type 2 diabetes remission (March 2019)
• The two year outcome of the DiRECT trial (March 2019)
• the press release that ‘Weight loss puts Type 2 diabetes into remission for at least two years (March 2019)
• the press release that is ‘Proof that new diet CAN reverse diabetes’ (March 2019)
• the press release for 'Rebooting' insulin-producing cells key to Type 2 diabetes remission (August 2018) 
• Lecture Nutritional management and prevention of type 2 diabetes delivered at the Swiss Re Institute's "Food for thought: The science and politics of nutrition" (June 2018)
• the Fixing Dad Prudential Ride London 2017 
• the press release for Fixing Dad (July 2016)
• Advice on reversing your type 2 diabetes (June 2016)
• Lecture on the up to date state of the research on reversing type 2 diabetes delivered to the Diabetes UK meeting (March 2016)
• Reversing the irreversible: Type 2 diabetes and you (October 2014)
• Hairy Dieters: How to love food and lose weight (BBC2 August 2012, repeated January 2013)
• Reversing the irrevesible: Type 2 diabetes and you (You Tube, 4th Oct 2014) (Lecture to Newcastle University Staff, 2016)
• Providing Patients A Life Without Diabetes (Podcast for doctors, 2020)
• Reversing Diabetes with Prof Roy Taylor (Metagenics Institute, Apple Podcast, 2021)
• EASD23 - Interview - Prof. Roy Taylor
• EASD24 – Interview – Prof Roy Taylor
• Losing weight to reverse type 2 diabetes
• Can you reverse type 2 diabetes?

Further information on the Hairy Dieters programme including experts' hints and tips and regular updates on the Hairy Dieters' progress can be seen on the BBC website. The programme promoted the University's aim to help us all live healthy, longer lives 

Recipes and meal plans are included in Professor Taylor’s book ‘Life Without Diabetes’

Other sample recipes and meal plans have been devised by Alison Barnes, Senior Diabetes Dietitian, Newcastle University and Tom Crame, Dietitian Intern, Newcastle University.
Guoda Karoblyte, Human Nutrition placement student at Newcastle University has also devised some 'More vegetable recipes'.

More information on low calorie diets is available from the Diabetes UK website and the British Heart Foundation provide advice on weight loss.

From the pioneer of diabetes reversal whose research is behind the new NHS programme to reverse type 2 diabetes
Prof Roy Taylor is one of the world's leading experts in type 2 diabetes, the man who discovered that this life-limiting disease was actually a reversible condition.

With his team of researchers at Newcastle University, he launched a series of studies culminating in a multi-million-pound trial, which confirmed that simple advice about diet could bring about lasting remission.

In Life Without Diabetes, Taylor brings all the knowledge and experience of four decades of treating people with diabetes. He explains exactly what is happening in the body as type 2 develops and presents a brilliant 3-step weight loss plan that will enable you to reverse your type 2 and live a full and healthy life beyond it.

Bestseller 'Life Without Diabetes' by Prof Roy Taylor is available now from online retailers and book stores. E-Book and Audio versions narrated by Prof Roy Taylor can be found online. 

Contents:
Foreward by Professor Sir George Alberti
A personal note: Dave Myers, Hairy Biker
How to use this book
Introduction

1. What is type 2 diabetes? 
2. Energy for life: the dual fual
3. How your body deals with food
4. Type 2 diabetes: a bad case of food poisoning 
5. A murder mystery and the Twin Cycles 
6. The Personal Fat Threshold
7. Escaping from type 2 diabetes
8. Enjoying life and staying away from diabetes 
9. Don't be fooled 
10. Recipes 

The following are suitable liquid replacement meals as described in Life Without Diabetes:

These all provide 200 calories per meal: Kee Diet and New You Plan.  

Life Without Diabetes explains everything you need to know about type 2 diabetes in simple language. However, a shorter description of how to achieve remission of type 2 diabetes is also available – ‘Your Simple Guide to Reversing Type 2 Diabetes’.