Claims that People with Type 2 Diabetes Can Reverse Their Condition
WHAT IS THE TRENDING NEWS STORY
A diabetes breakthrough is revealed to be twice as effective as the leading type 2 drug at normalizing blood sugar. Studies show how patients are able to fix insulin resistance, reduce neuropathy pain, prevent blindness, amputations and other diabetes problems. Yet, hundreds of studies show otherwise.
WHY THE STORY HAS MISINFORMATION
The World Health Organization (WHO) has shown that adherence to long-term therapy for chronic illnesses such as diabetes in developed countries averages only around 50%. The majority of patients with type 2 diabetes mellitus (DM) fail to control the disease (hyperglycemia; high blood sugar level) with diet and exercise only and require drug therapy.
The Look AHEAD (Action for Health in Diabetes) study, conducted from 2001 to 2012, studied the effects of intensive lifestyle interventions on patients with DM, targeting weight reduction through caloric restriction and increased physical activity. In this study, 2,575 participants were randomized to a control group and 2,570 to an intervention that consisted of a weekly goal for physical activity. After the first year, greater weight loss was observed in the intervention arm (8.6%) compared with the usual care arm (0.7%), and this impact was sustained (although diminished) by the end of the study (6.0% versus 3.5%). The patients in the intervention arm, apart from the benefits of weight loss, had improved physical fitness and HDL cholesterol (HDL-C) levels. They also had greater reductions in A1c and waist circumference, and required less medication for glucose (not suspension), blood pressure, and lipid control.
Other studies consider functional foods rich in natural fibers useful for people with diabetes. The soluble fibers present in this kind of food can modify starch digestion and improve postprandial glucose response, and because of this reason they are some of the most-widely studied and employed. One of those studies particularly considered the substitution of regular white bread with a functional bread, starch-restricted and rich in fiber (mostly beta glucans), into the everyday diet of patients with type 2 diabetes. After around a six-month observation period, researchers concluded that this intervention could improve the medium- to long-term glycemic control in type 2DM in addition to the drugs used to control the blood glucose.
Other substances considered are the phenolic compounds found in edible plants, that with time have attracted increasing attention due to their efficacy for the prevention of diabetes. Spices are the main sources of dietary phenolic compounds, with polyphenols found in around 80 spices exhibiting effects related to the prevention and control of diabetes. For example, there is evidence that states that the use of 2 gram per day of Nigella sativa might be a beneficial adjuvant to oral hypoglycemic agents in type 2 DM patients. Other literature points out that turmeric supplementation as an adjuvant to Type 2 DM on metformin treatment had a beneficial effect on blood glucose, oxidative stress, and inflammation. These components are considered to be beneficial as adjuvant therapies, but patients should consume spices with caution due to their potential adverse effects over the long term.
Lifestyle changes are indicated to reduce the cardiovascular risk in patients with DM. Researchers from the Primary Prevention of Diabetes Program in Buenos Aires Province (PPDBA) evaluated the effectiveness of adopting healthy lifestyle changes to prevent type 2 DM in people at high risk of developing the condition. After following up 3,759 patients with sufficient criteria for pre-diabetes and type 2 DM, they concluded that these conditions were associated with dyslipidemia and insulin resistance which unequivocally promotes the development of type 2 DM and cardiovascular disease, considering lifestyle changes insufficient for prevention and in dire need of appropriate treatment.
There is also some belief that points out that the use of certain dietary supplements may reduce and reverse the progression of type 1 diabetes. Current literature concurs that, theoretically, long-term consumption of omega-3 polyunsaturated fatty acids (PUFAs) is known to suppress inflammatory processes, making these fatty acids candidates for the prevention and amelioration of autoimmune diseases, like type 1 diabetes. In a study published by The Journal of Clinical Investigation in May 2017; researchers used non-obese diabetic mice (NOD mice) to explore this potential purpose. One group was fed a diet containing enriched EPA/DHA for 35 weeks, starting at 5 weeks of age, and a control group was fed a regular diet during the same period. Non-fasting blood glucose concentrations were used to monitor the incidence of diabetes, with 80% of female NOD mice in the control group developing diabetes by the age of 40 weeks. In contrast, only 33% of the mice fed an EPA/DHA-enriched diet were diagnosed with diabetes making a very early suggestion, in an animal model, that omega-3 PUFAs could potentially serve as a therapeutic modality for type 1 diabetes. However, we must remember that animal experiments are often poor predictors of human reactions to exposure, and because of this further studies are needed as these results could end up being misleading and should not be considered definitive. Though far from perfect, islet transplants are now the only proven, definitive treatment for type 1 diabetes.
Regarding leukotriene B4 (LTB4 ), it is a potential target that showed promising results at in-vitro testing. It is a pro-inflammatory molecule recently discovered to be directly involved with insulin resistance in mouse and human cells, which are highly expressed in the obese state, and theoretically, the molecule can be targeted both genetically and pharmacologically to improve insulin sensitivity in vivo, but translating these potential therapies into the human setting remains challenging. Reduction in LTB4 production or activity may reduce sterile inflammation and decrease disease severity, but this is still a work in progress.
Nutritional supplements such as vitamin B12 were also considered as a subject for the study regarding its association with diabetic neuropathy. Four studies comprising of 363 patients were analyzed, and this review found no evidence that the use of oral vitamin B12 supplements was associated with improvement in the clinical symptoms or in the electrophysiological markers of nerve conduction of diabetic neuropathy. Other substances, like alpha lipoic acid, acetyl L-carnitine and primrose oil were other substances considered to influence an effect on diabetic neuropathy, but none of them had sufficient or powerful enough evidence to avail it.
Even though there is enough evidence to prove that some adjuvant therapies might have a positive influence on DM treatment, evidence pointing out at adjuvant or non-traditional measures to substitute current guidelines of treatment is insufficient or non-existent. This makes current guideline therapy the gold standard to increase life expectancy, reduce complications, and ensure metabolic control of patients with DM.