Diet under pharmacist supervision puts Type 2 diabetes into remission, study finds

14 Sep 2021 --- Individuals can control their Type 2 diabetes (T2D) through diet, and pharmacists are well-positioned to supervise the transition. One-third of participants with T2D were off all diabetes medications at the end of a twelve-week study after following a low calorie, low carbohydrate, higher protein diet.

“The key piece of information this study provides is in the intervention delivery – pharmacists are well-positioned to help patients in the community to safely deprescribe medications,” Jonathan Little, associate professor at the University of British Columbia’s Okanagan School of Health and Exercise Sciences, tells NutritionInsight.

“With all the previous diet studies and the clinical practice guidelines, we currently have no real guidance on how to take medications away and how to implement this if patients choose to follow a low-calorie or low-carbohydrate diet.”

Pharmacists could be a key player in quarterbacking interventions that are aimed at T2D remission/reversal where medications need to be safely deprescribed, Little notes.

Mitacs, a Canadian research organization, partially funded the study with salary support provided to Little from the Canadian Institutes for Health Research and the Michael Smith Foundation for Health Research.

Effects of a change in diet
The research, published in the Journal of Nature Communications, was part of a 12-week study involving a specialized diet managed by local pharmacists.

The study participants, all living with Type 2 diabetes, were given a meal plan of low-calorie, low-carbohydrate, higher-protein foods. They checked in regularly with their pharmacist, who could monitor their medications.Jonathan Little, associate professor in UBC Okanagan’s School of Health and Exercise Sciences (Credit: UBC Okanagan).

Half of the participants in the study followed the low-calorie, low-carbohydrate, higher-protein diet, regularly checking with their pharmacist. The first group noted substantial improvements to their glucose control, average body weight, systolic blood pressure and overall health, Additionally, they did not need medication for diabetes.

“T2D can be treated, and sometimes reversed, with dietary interventions. However, we needed a strategy to help people implement these interventions while keeping an eye on their medication changes,” adds Little.

“The intervention was effective in reducing the need for glucose-lowering medications for many in our study,” says Alan Batterham, professor in the School of Health and Life Sciences at Teesside University.

“This indicates that community pharmacists are a viable and innovative option for implementing short-term nutritional interventions for people with T2D, particularly when medication management is a safety concern.”

Low-calorie, low-carbohydrate and higher-protein diet
The low-calorie approach is key to losing weight. Low-carbohydrate in the study helped the pharmacists deprescribe medications in a predictable manner, notes Little.Dietary changes are proving to be an essential aid in the treatment of Type 2 diabetes.

“The higher-protein was to try to help maintain muscle mass while losing weight – we know that when you follow a low-calorie diet, you will lose both fat (which is good) and muscle (which is not so good) – ensuring adequate protein can help to preserve muscle mass during intensive weight loss.”

It appears that substantial (10 to 12 kgs) weight loss is needed to “reverse” T2D, comments Little.

“With this amount of weight loss, you are losing body fat, and it seems that, in particular, draining of liver fat is needed to help the liver restore its function and stop releasing too much glucose out into the blood.”

In the study, there was evidence that while participants were coming off their glucose-lowering or diabetes medications and losing weight, they saw improved blood sugar control and evidence of improved liver function, explains Little.

“It is true that most T2D medications treat the symptom hyperglycemia and not the root cause.” concludes Little.

Echoing the notion that diet can treat health conditions, an IDEO designer previously revealed food can be preventative medicine for “reshaping the healthcare system.”

Tackling Type 2 diabetes
Industry players have shown interest in reducing symptoms of diabetes through nutrition and exercise. Recently, the National Health Service (NHS) in the UK set up a program to help people with T2D go into remission through a change in diet and support for increased exercise.

Meanwhile, US-based Simplex Health launched FitNatal to lower gestational diabetes through exercise, and UK-based researchers find that vegan protein shakes may be more suitable than whey for diabetes.

By Nicole Kerr