Type 2 diabetes (T2DM) is a growing health issue globally, which, until recently, was considered to be both chronic and progressive. Although having lifestyle and dietary changes as core components, treatments have focused on optimising glycaemic control using pharmaceutical agents. With data from bariatric surgery and, more recently, total diet replacement (TDR) studies that have set out to achieve remission, remission of T2DM has emerged as a treatment goal. A group of specialist dietitians and medical practitioners was convened, supported by the British Dietetic Association and Diabetes UK, to discuss dietary approaches to T2DM and consequently undertook a review of the available clinical trial and practice audit data regarding dietary approaches to remission of T2DM. Current available evidence suggests that a range of dietary approaches, including low energy diets (mostly using TDR) and low carbohydrate diets, can be used to support the achievement of euglycaemia and potentially remission. The most significant predictor of remission is weight loss and, although euglycaemia may occur on a low carbohydrate diet without weight loss, which does not meet some definitions of remission, it may rather constitute a ‘state of mitigation’ of T2DM. This technical point may not be considered as important for people living with T2DM, aside from that it may only last as long as the carbohydrate restriction is maintained. The possibility of actively treating T2DM along with the possibility of achieving remission should be discussed by healthcare professionals with people living with T2DM, along with a range of different dietary approaches that can help to achieve this.
Bibliographical noteThis is the peer reviewed version of the following article: Brown, A., McArdle, P., Taplin, J., Unwin, D., Unwin, J., Deakin, T., Wheatley, S., Murdoch, C., Malhotra, A. and Mellor, D. (2021), Dietary strategies for remission of type 2 diabetes: A narrative review. J Hum Nutr Diet. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/jhn.12938. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
The authors acknowledge the support of the British Dietetic Association in helping to arrange and facilitate the meeting of this group and Diabetes UK for hosting the initial discussions. In addition, the authors acknowledge the contributions of the others in attendance at this meeting (Andrew Burman, Thomas Embury, Dr Pamela Dyson, Dr Nicola Guess and Douglas Twenefour).
- therapeutic areas
- dietary intervention
- food intake
- cellular and physiological function