You can prevent type 2 diabetes with healthy lifestyle choices
You can reverse type 2 diabetes
British medical doctor and researcher Roy Taylor, along with his colleagues, determined how type 2 diabetes develops. Taylor’s recent book, Life Without Diabetes, tells the story. The sequence begins with prolonged overeating—more calories than you burn—over several years. Long-term overeating leads to excess calories being stored as fat. Where this fat is stored matters a lot. Subcutaneous fat (under the skin) does not create higher risk for type 2 diabetes. However, at some point, the storage capacity of fat cells under the skin is exceeded. At that point, internal organs, including the liver, store excess fat. Too much fat in the liver causes it to become resistant to insulin, which causes the liver to excrete glucose (blood sugar) instead of storing it in the liver as glycogen. Blood glucose and insulin levels rise as a consequence.
When the liver can’t store more fat, the pancreas stores fat. Over several years, excess fat in the pancreas inactivates specialized pancreatic beta cells located in small nodules that produce insulin. This leads to lower insulin production in the pancreas and, as a result, higher blood glucose.
High body-mass index predicts greater risk of developing type 2 diabetes. But curiously, people can be obese and not become diabetic, while normal weight people can become diabetic. Taylor and Holman explain this apparent contradiction by proposing that each individual has a personal fat threshold, above which the pancreatic beta cells don’t function properly. Thus, people with a high personal fat threshold can be obese without becoming diabetic. Normal-weight people with a low fat threshold can become diabetic.
Over the years, clinicians noticed and long-term studies showed that type 2 patients continued to be diabetic as the years passed. The medical establishment regarded type 2 diabetes as irreversible. But some patients did resolve their diabetes. How could this be? Taylor and Holman realized that long-term studies did not account for the fact that the vast majority of diabetic participants gained weight over time. Given the existence of a personal fat threshold, weight gain (mainly as fat) would continue to exceed the personal fat threshold and diabetes would continue. But patients who lost a lot of weight could fall back below their personal fat threshold and reverse their diabetes.
A key part of this story came from non-invasive imaging studies of livers and pancreases of type 2 diabetic and non-diabetic persons. Images showed that these organs of type 2 diabetics contained much more fat than those of non-diabetic persons. This evidence supports the idea that fat in the liver and pancreas caused type 2 diabetes. In addition, images showed that the inactive beta cells of diabetic patients could become active and produce insulin following substantial weight loss. The accompanying loss of fat would help account for the ability of at least some patients to reverse diabetes after major weight loss.
Earlier research by Taylor and colleagues reached type 2 diabetics throughout the world. Many diabetic persons emailed Taylor asking for guidance to reverse their diabetes. Feedback from those people revealed that patients who received recent diabetes diagnoses—less than four years—were more likely to reverse their type 2 diabetes than people with long-standing diabetes. Evidently, there’s a limit to how long inactive pancreas beta cells can recommence insulin production after large weight loss, but the limit varies with the individual.
For a person with recently diagnosed type 2 diabetes, Taylor proposes a three-phase strategy to reverse diabetes. Phase 1: Employ a very low-calorie diet to lose a lot of weight in a hurry (15 percent of your body weight over 2-3 months). Phase 2: Transition to a normal food diet over a month. Phase 3: Eat regular food that you like that provides about three-quarters of the previous level of calories. Limiting fast-food and frozen, prepared meals will help reduce your caloric intake. Monitor your weight weekly. Ramp up your level of physical activity. Garner support from family and friends starting in Phase 1 to greatly increase your likelihood of reversing type 2 diabetes. If all this sounds appealing to you, consult with your health care provider to come up with a diabetes prevention or reversal program that works for you.
