Headline: New diet and exercise programme helps people with type 2 diabetes cut medication

ADELAIDE researchers have developed a diet and exercise program the CSIRO says has proven highly effective in reducing the burden of type 2 diabetes, including an average 40 per cent reduction in medication levels.

Some people in the trial were able to cease using their medication.

The diet is very low in carbohydrates and higher in protein and unsaturated fats.

The program is based on findings from a $1.3 million National Health and Medical Research Council funded study which compared the low carbohydrate eating pattern with the best practice approach of managing type 2 diabetes with a high-unrefined carbohydrate, low fat diet.

Principal research scientist at the CSIRO Associate Professor Grant Brinkworth said the results were groundbreaking.

“Health professionals have been divided over the best dietary approach for managing type 2 diabetes, and the ongoing uncertainty is a hotly debated topic among clinicians and researchers,” he said.

“The most amazing benefit of the low carbohydrate diet was the reduction in the patient’s medication levels, which was more than double the amount than the volunteers following the lifestyle program with the high-carbohydrate diet plan.

“Some of the participants managed to cease their medications altogether, and many described the study as life changing.

“This research shows traditional dietary approaches for managing type 2 diabetes could be outdated — we really need to review the current dietary guidelines if we are serious about using the latest scientific evidence to reduce the impact of the disease.”

The two-year research program was a collaboration between CSIRO, the University of Adelaide, Flinders University and the University of South Australia, with the exercise program carried out at local fitness centres.

Professor Campbell Thompson, from the University of Adelaide, said the very low carbohydrate diet presented greater improvements in the blood cholesterol profile by increasing the levels of ‘good’ (HDL) cholesterol and decreasing triglyceride levels to a greater extent than the traditional high carbohydrate, low fat diet approach.

“Both diets achieved similar reductions in ‘bad’ (LDL) cholesterol levels, often a concern with some low carbohydrate diets,” he said.

“The variability of blood glucose levels throughout the day is also emerging as a strong independent risk factor for diabetes complications. In our study the very low carbohydrate diet was more effective in reducing the number and levels of blood glucose spikes and dips, flattening the blood glucose profile over a 24-hour period.”

More than 350 million people worldwide have Type 2 diabetes, and with obesity a major risk factor, the number is expected to grow.

An estimated 800,000 Australian adults have type 2 diabetes with many more undiagnosed, with around $490 million spent on related medications in 2008-09.

Notes

• No mention whatsoever about the exercise programme mentioned in the title! Although CSIROs webpage does mention it was undertaken in partnership with community fitness centres, but no description of it (CSIRO, 2016).
• Diabetes Figures:
  • CSIRO’s book ‘The CSIRO and Baker IDI Diabetes Diet and Lifestyle Plan’ which was published in 2013 states “More than 1.5 million Australians have diabetes, and more than twice that number are likely to develop diabetes in the next 5 to 10 years.” (CSIRO, 2013, p.3).
  • Australian adults (5%), about 917,000 people, had diabetes in 2011–12, based on self-reported and measured data (AIHW, 2015).
  • Around 1.7 million Australians have diabetes. This includes all types of diagnosed diabetes (1.2 million known and registered) as well as silent, undiagnosed type 2 diabetes (up to 500,000 estimated) (Diabetes Australia, 2015a). No source is given for this figure.
  • There were over 1 million cases of diabetes in Australia in 2015 (IDF, 2015).
  • In 2013, 1,648,860 diabetes cases and 814,540 undiagnosed cases (IDF, 2014).
  • A Diabetes Map, produced by Diabetes Australia (2015b), can be found here.
• Approximately 80%-90% of people with diabetes have type 2.
• Factors which influence someone’s risk of type 2 diabetes include: weight, waist circumference, age, physical activity and whether or not they have a previous history of gestational diabetes or a family history of type 2 diabetes (NICE, 2016).
• The UKs National Institute for Health and Care Excellence (Known as NICE) produces well-rounded guidance on the broad subject that is diabetes.
• The Australian Dietary Guidelines 2013 published by the National Health and Medical Research Council (the organisation who paid CSIRO to do the research) already state (Guideline 3) what has been noted in this research as landmark/breakthrough. The guidelines are still current/extant.
• Similar research was published in 2014 in Diabetes Care (Tay et al., 2014), which also had an exercise component.
• $498 million was spent on blood glucose lowering medications (AIHW, 2013), not $490 million (a small point but still inaccurate reporting).
• Type 2 diabetes accounted for at least 60% of diabetes expenditure in 2008-09,  with diabetes expenditure for hospital admitted patient services conservatively estimated at $647 million, and for out-of-hospital medical expenses it was $362 million (AIHW, 2013).

References

Crouch, B. (2016) New Diet and Exercise Program helps People with Type 2 Diabetes Cut Medication. Available from World Wide Web: http://www.adelaidenow.com.au/news/south-australia/new-diet-and-exercise-program-helps-people-with-type-2-diabetes-cut-mediation/news-story/5f53eae6220f65b89c0912d5294e0680?sv=4171fc7259e408b5092fa0abf35ed2e5#load-story-comments. [Accessed: 12 February, 2016].

CSIRO (Commonwealth Scientific and Industrial Research Organisation) (2013) The CSIRO and BAKER IDI Diabetes Diet and Lifestyle Plan. London: Penguin UK.

CSIRO (Commonwealth Scientific and Industrial Research Organisation) (2016) Improved Diabetes Control with New Diet. http://www.csiro.au/en/News/News-releases/2016/Improved-diabetes-control-with-new-diet. [Accessed: 12 February, 2016].

NICE (National Institute for Health and Care Excellence) (2016) Diabetes. Available from World Wide Web: https://www.nice.org.uk/guidance/conditions-and-diseases/diabetes-and-other-endocrinal–nutritional-and-metabolic-conditions/diabetes. [Accessed: 12 February, 2016].

NH&MRC (National Health and Medical Research Council) (2013) Australian Dietary Guidelines (2013). Available from World Wide Web: https://www.nhmrc.gov.au/guidelines-publications/n55. [Accessed: 12 February, 2016].

Tay, J., Luscomber-Marsh, N.D., Thompson, C.H., Noakes, M., Buckley, J.D., Witter, G.A., Yancy, W.S. Jr, & Brinkworth, J.D. (2014) A Very Low-Carbohydrate, Low-saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial. Diabetes Care. 37(11), pp.2909-2918. doi: 10.2337/dc14-0845. Epub 2014 Jul 28.

AIHW (Australian Institute for Health and Welfare) (2013) Diabetes Expenditure in Australia 2008-09. Available from World Wide Web: http://www.aihw.gov.au/publication-detail/?id=60129543925&tab=2. [Accessed: 12 February, 2016].

AIHW (Australian Institute for Health and Welfare) (2015) Diabetes. Available from World Wide Web: http://www.aihw.gov.au/diabetes/. [Accessed: 12 February, 2016].

Diabetes Australia (2015a) Diabetes in Australia. Available from World Wide Web: https://www.diabetesaustralia.com.au/diabetes-in-australia. [Accessed: 12 February, 2016].

Diabetes Australia (2015b) Diabetes Map. Available from World Wide Web: https://www.ndss.com.au/diabetes-map. [Accessed: 12 February, 2016].

IDF (Intenational Diabetes Federation) (2015) Australia. Available from World Wide Web: http://www.idf.org/membership/wp/australia. [Accessed: 12 February, 2016].

IDF (International Diabetes Federation) (2014) Global Diabetes Scorecard: Tracking Progress for Action. Available from World Wide Web: http://www.idf.org/global-diabetes-scorecard/. [Accessed: 12 February, 2016].