We can Reverse Diabetes (or can we?)

A decade earlier, reversal of diabetes was considered the ‘holy grail’ of medicine. Physicians dreamt of it but could not achieve it. Behind this failure was inadequate knowledge about physiology of diabetes. Research progressed, we got an insight into role of liver in generating and sustaining diabetes. When a person eats lots of saturated fats and calories, liver fat cells rapidly increase in numbers, and when the liver is full of fat, it starts to leak creamy substance (known as triglycerides) in the blood. Such cream has a great tendency to get deposited in muscle, pancreas, and heart arteries as well. Deposition in pancreas impairs functioning of vital insulin producing cells, thus critically decreasing in insulin levels in the body. The blood sugar rises and does not go down easily.

Having known this cascade of events now, the next big question was; how to remove this creamy layer from various organs? Simple solution is, take away the hand that feeds the cream! A nice experiment in the UK made it look all so easy and started the ball rolling for ‘reversal of diabetes”. Ten years ago, 12 patients with diabetes were given very low calorie liquid meals (less than half of daily requirement) for 8 weeks. Investigators were hugely surprised when blood sugar of all patients normalised within few days. Half of the fat/cream from liver and pancreas were rapidly gone in 4/6 weeks patients remained without medications for a short period of time.

An important question was if such remarkable results could be duplicated. Another study from the UK, carried out in patients living in community, employed the same principles of diet over one year. An interesting observation was that those who lost 10-15 kg weight normalised their blood glucose. Further, in some people this remission disappeared in about a year, and they were back to diabetic state. Since then, other experiments (and massive weight loss after bariatric surgery) have supported these observations.