How effective are low-calorie diets for the treatment of Type 2 Diabetes?

Hallberg, S. J., Gershuni, V. M., Hazbun, T. L., & Athinarayanan, S. J. (2019). Reversing Type 2
Diabetes: A Narrative Review of the Evidence. Nutrients, 11(4), 766.
https://doi.org/10.3390/nu11040766

The study outlines possible approaches to lessen or even reverse Type 2 Diabetes. It explored
three types of treatments: bariatric surgery, low calorie diets, or carbohydrate restriction and
the issue of long-term sustenance of such diets. The lack of long-term studies for low calorie
diets and carbohydrate restrictions were a drawback to the studies, but low calorie diets (<600
cal/day) were shown to normalize diabetes markers such as glucose, A1C, insulin sensitivity,
insulin response, etc.

Juray, S., Axen, K. V., & Trasino, S. E. (2021). Remission of Type 2 Diabetes with Very Low-
Calorie Diets-A Narrative Review. Nutrients, 13(6), 2086. https://doi.org/10.3390/nu13062086

The study began by noting that most research papers focus on the correlation between weight
loss and very-low-calorie diets (400-800 cals) instead of Type 2 Diabetes. It then explained the
correlation between weight loss and remission of Type 2 Diabetes, defining remission of T2D
based on glucose, A1C, and medication usage. The study found that T2D remission was
achieved to a significant degree on very-low-calorie diets.

Sellahewa, L., Khan, C., Lakkunarajah, S., & Idris, I. (2017). A Systematic Review of Evidence on
the Use of Very Low Calorie Diets in People with Diabetes. Current diabetes reviews, 13(1), 35–
46. https://doi.org/10.2174/1573399812666151005123431

Participants of this study were of diverse ages and follow-up durations (up to 5 years). The
conclusion showed a significant reduction in weight and the diabetic markers excluding the
drop-out rates. This suggests a correlation between obesity and type 2 diabetes.

Umphonsathien, M., Rattanasian, P., Lokattachariya, S., Suansawang, W., Boonyasuppayakorn,

K., & Khovidhunkit, W. (2022). Effects of intermittent very-low calorie diet on glycemic control
and cardiovascular risk factors in obese patients with type 2 diabetes mellitus: A randomized
controlled trial. Journal of diabetes investigation, 13(1), 156–166.
https://doi.org/10.1111/jdi.13619

This study assessed the effects of very-low-calorie-diets (600 cal/day) on “glycemic control,
diabetes remission, metabolic parameters, and quality of life in patients with type 2 diabetes
and obesity.” 29 percent of patients who participated in the diets experienced diabetes
remission. Overall, diabetes marker figures reduced significantly.
Taylor R. (2019). Calorie restriction for long-term remission of type 2 diabetes. Clinical medicine
(London, England), 19(1), 37–42. https://doi.org/10.7861/clinmedicine.19-1-37

A major part of this study deals with the processes behind development and remission of Type
2 Diabetes, namely the presence of fatty liver in diabetic individuals. It found that within seven
days of VLCD (very low calorie diet), liver fat levels dropped by 30% and liver insulin sensitivity
returned to normal. Within eight weeks, insulin secretion normalized. The study also
acknowledged the willpower of the person to stick to the diet as an important factor in the
efficacy of the treatment.

Williams, K., Mullen, M., Kelley, D., & Wing, R. (1998, January 01). Effect of short periods of
caloric restriction on weight loss and glycemic control in type 2 diabetes. Diabetes Care,
Retrieved October 16, 2022, from https://doi.org/10.2337/diacare.21.1.2

This study summarized the effects of VLCD on Type 2 Diabetes patients in conjunction with
standard behavioral therapy (SBT). Over a period of 20 weeks, more VLCD patients experienced
normalized A1C levels than SBT patients. There was also improved glycemic control in the VLCD
patients. This suggests that VLCD may ease Type 2 Diabetes based on the normalization of its
markers.

Meehan, C. A., Cochran, E., Mattingly, M., Gorden, P., & Brown, R. J. (2015). Mild Caloric
Restriction Decreases Insulin Requirements in Patients With Type 2 Diabetes and Severe Insulin
Resistance. Medicine, 94(30), e1160. https://doi.org/10.1097/MD.0000000000001160

This study aimed to make insulin administration more efficient by restricting patient calories.
Insulin administration decreased significantly. This suggests that consuming less calories
requires the panaceas to produce less insulin, meaning LCDs may facilitate the remission of
diabetes for affected patients.

Steven, S., & Taylor, R. (n.d.). Restoring normoglycaemia by use of a very low calorie diet in
long- and short-duration Type 2 diabetes. Diabetic Medicine, Retrieved October 16, 2022, from
https://onlinelibrary.wiley.com/doi/10.1111/dme.12722

This study gathered 29 T2D patients who were given VLCDs for 8 weeks. Decreases in A1C and
fasting plasma glucose levels were observed in the patients, both significant markers for the
remission of Diabetes Type 2, in addition to improvements in their lipid profile.
Willi, S., Martin, K., Datko, F., & Brant, B. (2004, February 01). Treatment of type 2 diabetes in
childhood using a very-low-calorie diet. Diabetes Care 1, Retrieved October 15, 2022, from
https://doi.org/10.2337/diacare.27.2.348

In this study, 11 out of 20 children were treated with insulin and 6 with metformin before
starting the diet. Both treatments showed significant decrease in A1C, BMI, and insulin
requirements.

Steven, S., Hollingsworth, K., Al-Mrabeh, A., Avery, L., Aribisala, B., Caslake, M., & Taylor, R.
(2016, March 21). Very low-calorie diet and 6 months of weight stability in type 2 diabetes:
Pathophysiological changes in responders and nonresponders. Diabetes Care 1, Retrieved
October 15, 2022, from s

In this study, individuals with varying durations of T2D partook in a VLCD for 8 weeks. 12 of 30
participants saw their A1C, plasma insulin level, and plasma glucose decrease significantly. This
suggests that VLCD may help remission of T2D.

Perry, R. J., Peng, L., Cline, G. W., Wang, Y., Rabin-Court, A., Song, J. D., Zhang, D., Zhang, X.-M.,
Nozaki, Y., Dufour, S., Petersen, K. F., &amp; Shulman, G. I. (2018, January 9). Mechanisms by
which a very-low-calorie diet reverses hyperglycemia in a rat model of type 2 diabetes. Cell
metabolism. Retrieved October 19, 2022, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762419/

This study covered the detailed mechanisms relevant to T2D which VLCDs act on. It emphasized
that the effects of VLCDs on metabolic parameters are unaffected by any present weight loss,
and the two can occur without the other. Its findings were consistent with that of previous
studies.