Restoring the first phase insulin response through weight loss and high dietary protein intake is essential for remission in type 2 diabetes.
Amino acids, such as those found in whey protein, can independently stimulate insulin secretion and aid in lowering blood glucose levels.
Reducing carbohydrate intake to around 30% of total calories and increasing protein intake to about 20-30% of total calories can significantly improve glycemic control in type 2 diabetes, even without weight loss.
Deep dives
Understanding the importance of the first phase insulin response
The first phase insulin response is crucial for controlling postprandial glucose levels. It allows the beta cells to release insulin in response to rising glucose levels and promote glucose uptake into tissues like muscles. The first phase insulin response declines in individuals with prediabetes and type 2 diabetes, leading to elevated postprandial glucose. Research shows that restoring the first phase insulin response is essential for remission in type 2 diabetes and can be achieved through weight loss and high dietary protein intake.
Amino acids and their impact on the beta cells
While beta cell dysfunction occurs in individuals with prediabetes and type 2 diabetes, the beta cells maintain their sensitivity to amino acids. Amino acids can stimulate insulin secretion independently of glucose, providing a potential pathway for improving glucose control. Studies have shown that high concentrations of amino acids, such as those found in whey protein, can lead to a significant increase in insulin secretion and aid in lowering blood glucose levels. Further research is being conducted to determine the most insulinogenic amino acids and their optimal dosages in the context of type 2 diabetes.
Replacing carbohydrates with protein
Reducing carbohydrate intake to around 30% of total calories and increasing protein intake to about 20-30% of total calories appears to be a beneficial approach for managing blood glucose levels in type 2 diabetes. Studies have shown that this combination can result in significant improvements in glycemic control, even in the absence of weight loss. Determining the optimal substitution of protein for carbohydrates in individual diet plans is an ongoing area of research.
Implementing the direct program for sustainable remission
The direct program, which utilizes a very low energy diet to achieve weight loss and remission in type 2 diabetes, has shown promising results. The program's implementation through primary care has demonstrated high recruitment rates and positive outcomes, including remission. The program's scalability and success in diverse populations, including those from disadvantaged backgrounds, highlights its potential for wider implementation. Ongoing research aims to explore alternative interventions that can achieve similar results without the need for extreme energy restriction.
The New Dawn study for extended remission
The New Dawn study at the University of Oxford aims to extend remission in type 2 diabetes by offering a sequence of weight loss programs tailored to individual preferences. By providing bite-sized trial periods and proactive support, the study seeks to improve participant adherence and explore alternative interventions if the initial program doesn't suit their needs. Behavioral science approaches are employed to ensure a patient-centered approach that focuses on finding the most suitable treatment for each individual.
Blood glucose responses play a crucial role in maintaining good health, and any abnormalities in glucose regulation can lead to several chronic conditions. Diabetes is one such disease that results from a lack of insulin production or the body’s inability to use insulin effectively, leading to elevated blood glucose levels.
There has been debate about what exactly constitues a “healthy” and “unhealthy” blood glucose response. While it is suggested that unhealthy blood glucose responses are characterized by erratic and unpredictable “spikes” in blood glucose levels, sometimes vague terminology leads to people worrying about normal blood glucose responses. This may be particularly related to the increasing prevalence of continuous glucose monitoring (CGM) devices that allow individuals to track their glucose levels in real-time. While these devices can be helpful for people with diabetes to manage their glucose levels, they can also lead to unnecessary concern and anxiety about small, normal glucose elevations.
In recent years exciting advances have been made in diabetes remission research. And off the back of that, more research has looked at various dietary interventions that could either directly impact remission, or act as an adjuct to other interventions.
In this discussion with Dr. Nicola Guess, we discuss a range of topics related to glycemia, diabetes, and diet. This includes the potential for high-protein interventions, what utility CGMs actually have, what to make of diabetes remission trials, and future directions for the field.
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode