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. 2021 Jul 7:374:n1449.
doi: 10.1136/bmj.n1449.

Nutritional basis of type 2 diabetes remission

Roy Taylor  1 , Ambady Ramachandran  2   3 , William S Yancy Jr  4 , Nita G Forouhi  5
Affiliations

Nutritional basis of type 2 diabetes remission

Roy Taylor et al. BMJ. .

Erratum in

Abstract

Roy Taylor and colleagues explain how type 2 diabetes can be reversed by weight loss and avoidance of weight regain

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Conflict of interest statement

Competing interests: RT and NGF are unpaid members of the Joint SACN/NHS-England/Diabetes-UK Working Group to review the evidence on lower carbohydrate diets compared with current government advice for adults with type 2 diabetes. RT has received fees for educational lectures from Lilly and Janssen and is author of Life Without Diabetes (Short Books). WY is a member of the medical review board for dietdoctor.com and has contributed to guidelines for American Diabetes Association and Guideline Central regarding nutrition and health. The views expressed are the authors’ own. RT has research funding from Diabetes UK (17/0005645 and 13/0004691). NGF was supported by Medical Research Council Epidemiology Unit (MC_UU_00006/3) and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014) and NGF is a NIHR Senior Investigator. The views expressed are those of the authors and not necessarily those of the NIHR, the Department of Health and Social Care, or any other organisations they are associated with.

Figures

Fig 1
Fig 1
Type 2 diabetes develops as long term intake of excess food energy leads to accumulation of liver fat, driven by a vicious cycle of hepatic insulin resistance and hyperinsulinaemia. The raised liver fat level causes increased hepatic export of very low density lipoprotein (VLDL) triglycerides. If the subcutaneous fat depot cannot accommodate this, ectopic fat will build up, including in the pancreas. In people with susceptible β cells, the acute insulin response to food becomes diminished and de novo lipogenesis from glucose is enhanced. β Cell function can be restored if liver fat is reduced through weight loss. Figure is modified from Al-Mrabeh et al with permission
See this image and copyright information in PMC

References

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    1. Steven S, Hollingsworth KG, Al-Mrabeh A, et al. . Very low-calorie diet and 6 months of weight stability in type 2 diabetes: pathophysiological changes in responders and nonresponders. Diabetes Care 2016;39:808-15. 10.2337/dc15-1942 - DOI - PubMed
    1. Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, et al. . Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for β cell recovery. Cell Metab 2018;28:547-556.e3. 10.1016/j.cmet.2018.07.003 - DOI - PubMed
    1. Nagi D, Hambling C, Taylor R. Remission of type 2 diabetes: a position statement from the Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS). British Journal of Diabetes. 2019;19:73-6 10.15277/bjd.2019.221 - DOI
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