Reality check: Can you reverse diabetes by changing your diet? – National

Diabetes is a chronic condition that affects approximately three million Canadians, according to Statistics Canada.

There are two main kinds of diabetes: Type 1 and Type 2. If left untreated, the illness can lead to blindness, kidney failure, heart problems, neuropathic pain and amputations.

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The causes of diabetes have long been debated. Type 1 is typically considered to be hereditary, while Type 2 has been associated with obesity and inactivity.

Historically, both types have been considered inevitably degenerative — but that may no longer be the case.

Some doctors believe Type 2 — which affects 90 per cent of people living with diabetes, according to Diabetes Canada — can be reversed by a dramatic change in diet and activity levels.

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A 2017 study published in the BMJ found that patients who lost a significant amount of weight (about 33 pounds) were able to send diabetes into remission. Researchers define this as “no longer having diabetes, at least for a period.”

A similar 2019 study conducted at the University of British Columbia found that reducing or eliminating a specific protein in the fat cells of mice not only prevents the onset of Type 2 diabetes, but also appears to reverse the disease as well.

That protein, dubbed CD248, was found to be higher in the fat cells of people with diabetes regardless of their shape and size, but would decrease to normal levels when people with obesity-associated diabetes reversed the disease through weight loss.

A new way to treat Type 2 diabetes

“When we talk about diabetes remission or reversal, we’re almost exclusively talking about Type 2 diabetes,” Dr. Jason Fung, a nephrologist at Scarborough Health Network. He calls Type 2 diabetes a “dietary disease.”

“If you think about Type 2 diabetes, the entire disease is essentially too much sugar in the body,” said Fung.

“Sugar is both glucose, which comes from refined carbohydrates, and fructose. Your body is trying to shove all this glucose into the cell, [but if] you have too much of it, some of this glucose basically spills out into the blood.”

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Fung believes doctors have made a “big mistake” in trying to treat Type 2 diabetes with drugs instead of prescribing a low-carbohydrate diet. He compares a human body to a car to draw an analogy.

“Think of glucose or sugar as fuel — the fuel your body uses as energy, just like you use gas in your car,” said Fung.

Imagine pumping gas into your car so frequently that the gas tank overflows into the backseat of your car and makes you sick.

“Now you know what the problem is. Are you going to keep pumping gas into your car? No,” he explained.

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Jeffrey Johnson, a pharmacist and professor at the University of Alberta, agrees.

Lifestyle changes such as “dietary changes and [increased] physical activity” have been shown to prevent — and even reverse — Type 2 diabetes.

“A healthier diet and physical activity, like getting 150 minutes of moderate exercise every week… was enough to prevent people at risk of developing diabetes from being diagnosed,” said Johnson.

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Johnson offered his father as an example.

“He was diagnosed with Type 2 diabetes. He was treated with medication, and with time, he changed his lifestyle,” he continued.

“He lost weight, changed his diet and [added] physical activity. He got his blood sugar under control and he was able to stop medication.”

However, Johnson warns that Type 2 diabetes is not always reversible.

“Some people get Type 2 diabetes just as they get older. They might not be overweight or obese,” he said. “For some people, it might not be reversible but for a large portion of the population, it is.”

Diet vs. losing weight?

While weight loss can be a consequence of a low-carbohydrate diet, Fung emphasizes that it doesn’t need to be the end goal.

“Both are important […] but not all types of body fat are equal,” he said. “We’ve focused mostly on getting people better, whether they’re overweight or not.

“There are a lot of people who have Type 2 diabetes who wouldn’t be classified as overweight.”

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In Fung’s practice, he focuses more on getting people “metabolically healthy” as opposed to setting weight loss goals.

Increasing daily activity can help, but changing your diet will have the most impact.

“Burning an extra 150 calories by exercising is minuscule — it’s like five per cent of the 2,000 calories you eat in one day,” he said.

“If you have an exam and 95 per cent is English and five per cent of the exam is math, you don’t study each [for 50 per cent] of the time.”

Finding the diet that’s right for you

“There are a lot of different dietary recommendations that can help people lose weight,” he said.

If you are interested in trying to treat Type 2 diabetes with a new diet, he suggests consulting a dietitian first.

“The most important things are starting to track and notice what you’re eating… It could even just be reduced portion sizes,” he said. “Simple decisions like that.”

— With files from Sean Boynton

 

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