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NHS hails ‘life-changing’ diet programme to fight diabetes

Eating soup and shakes could reverse type 2 diabetes in half of cases

https://www.thetimes.co.uk/edition/...betes-p8ll5p8j9

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A diet of soups and shakes will be provided by the NHS for type 2 diabetes patients from today after studies showed that it reversed the condition in nearly half of cases.

The food will be prescribed to 5,000 patients for three months and include “total diet replacement products”, such as specially formulated low-calorie shakes and soups. The regime restricts them to 800 calories a day.

The national scheme, described by the NHS as “life-changing”, comes after trials showed that dramatic weight loss had led to diabetes going into remission.

A study in the UK in 2017 found that 46 per cent of type 2 patients who were placed on an ultra low-calorie diet needed no medication a year later. Some 70 per cent of those patients were still in remission after two years.

In type 2 diabetes not enough insulin is made in the pancreas or it does not work properly, leading to dangerously high blood sugar levels. Five million people in Britain have the condition, which can greatly affect everyday life and lead to amputations and blindness.

Studies increasingly show that significant weight loss reduces fat in the pancreas, allowing it to recover the ability to produce insulin.

The specially formulated food will be given to selected patients in England who have had the condition for at least six years. Alongside the food plan, they will be encouraged to take more exercise and given advice and coaching about reintroducing healthy meals.

If successful, the treatment could reduce the £10 billion a year spent by the NHS on type 2 cases. Almost 5 per cent of prescriptions are written to treat diabetes. Patients are also at twice the risk of dying from the coronavirus and a third of people who died in hospital with the virus had diabetes.

Tam Fry, chairman of the National Obesity Forum, said: “If your GP suggests this treatment for you, go for it. Though reducing your calorie intake to some 800 a day may not be easy at first, persist with the diet since it has been proven in several trials to work.”

In July the NHS announced that people at risk of developing type 2 diabetes could self-refer to specialist services in an effort to curb one of the biggest risk factors in Covid-19 deaths.

A study published last week by the University of North Carolina found that obese people are 113 per cent more likely to be admitted to hospital with coronavirus symptoms and 74 per cent more likely to need intensive care treatment.

The diet programme will be available initially to patients in ten areas of England and will be accessible to people who have had type 2 diabetes diagnosed in the past six years.

Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity, said: “There has never been a more important time to lose weight and put type 2 diabetes into remission, so it’s good news for thousands of people across the country that practical, supportive measures like this are increasingly available on the NHS.”

Bridget Turner, director of policy campaigns and improvement at Diabetes UK, said the programme was “an important first step” for patients to access a remission programme within the NHS.

“We know that some people with type 2 diabetes want and need support from healthcare professionals to lose weight effectively, and now as these programmes are piloted across the NHS they will,” she said. “People with type 2 diabetes who have put their diabetes into remission frequently tell us how it has changed their lives.

“We are so pleased to see that others will now have the same opportunity.”

In 2017 results from a trial in 298 type 2 diabetics showed that 46 per cent of those on an ultra-low-calorie food replacement diet of 800 calories a day for three to five months were in remission with no need for medication a year later. Some 70 per cent of those patients were still in remission two years later and had maintained an average weight loss of 10.4kg (one and half stone).

Analysis

The idea of being able to effectively diet your way into remission from type 2 diabetes is a relatively new field of study and hugely exciting for the five million people in Britain who have the disease.

It was only in 2017 that a study in the UK found that putting a person with type 2 diabetes on an intensive weight loss programme could reverse the disease with no need for medication.

Almost half of the participants in the weight-loss trial that used low-calorie shakes and soups were in remission after 12 months. After two years, 70 per cent of those people were still in remission. In comparison, only 4 per cent of those in the trial who were just given standard GP care for diabetes went into remission.

The relatively straightforward method also produces the same results as bariatric surgery, such as gastric bands or bypasses, but is far less risky and expensive for the NHS. Treating type 2 diabetes and its complications costs the NHS an average of £10 billion a year.

This rollout of a diet plan to 5,000 patients also comes at a crucial time as winter nears and the risk of getting coronavirus may begin to creep up again. NHS research has shown that the risk of dying from Covid-19 is doubled for patients with diabetes.

The dietary advice given out in the programme is not much different from that given by the NHS more generally. What is different is the counselling that goes with it. This is important, as the ability to keep the weight loss down long-term will be the greater challenge for the NHS, and patients must not be abandoned beyond the initial phase of dieting.