What causes diabetes
Diabetes is caused by too much glucose in the blood, either
due to the pancreas not producing enough insulin — the hormone which mops up
glucose — or because the body is no longer responsive to it, known as insulin
sensitivity.
Being overweight or obese is a major risk factor for type 2
diabetes because the body’s cells become less responsive to the effects of
insulin.
The usual treatment for type 2 diabetes is diet and
lifestyle changes and taking metformin, a drug that boosts the amount of
insulin taken up by the cells. In more severe cases, patients need to inject
themselves with insulin.
It’s now widely accepted that gastric surgery can reverse
type 2 diabetes.
This is because the surgery seems to trigger hormonal
changes which kick-start the pancreas, causing it to release more insulin almost
instantly.
Meanwhile, the body’s cells also become more sensitive to
insulin — as a result patients no longer need medication. The new study showed
that a low-calorie diet could have the same effect.
As Roy Taylor, professor of medicine and metabolism at the
University of Newcastle, who led the study, explains: ‘It’s now clear that type
2 diabetes is caused by abnormal fat storage. If you are eating more than you
burn, then the excess is stored in the liver and pancreas as fat.
‘On this diet, the mechanism is similar to what happens
after bariatric surgery — the body is suddenly in negative calorie balance, so
it calls on its own reserves of fat.
‘The fat used first is that around the pancreas and liver.
This means the pancreas is given a chance to start working again.’
Alcohol is banned, while patients are encouraged to drink
three litres of water a day.
Insulin lowers blood sugar and cuts down the loss of sugar
in the urine, explains Professor Taylor — meaning that calories are no longer
lost in this way. It can also stimulate the appetite directly.
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