A Cure for Diabetes?

Diabetes can be reversed. The key is in your diet.

According to the National Diabetes Institute (NADI), Malaysia has the highest rate of diabetes in Asia, with 2.5 million adults affected. It is also one of the highest in the world. What’s even more alarming is that these statistics suggest that almost half of Malaysians don’t even know that they have diabetes until they suffer from a heart attack, stroke or kidney failure. By then, the complications from diabetes have seriously impacted their quality of life, resigning them to the never-ending demands of the disease as well as mental symptoms such as depression over lost health or fear of future complications. The irony is that quality of life is the cause of the disease in the first place, in particular Type 2 diabetes – the most common form Malaysians suffer from. Type 2 diabetes is often linked to being overweight as well as a lack of exercise. It is a progressive disease where the blood glucose keeps climbing up with time. The longer you wait to do something about it, the more serious the disease becomes. It’s a vicious cycle – extra weight means more glucose is required to fuel the body, which means more insulin needs to be produced to allow glucose into the body’s cells. As insulin levels increase, those with predisposing genes start developing a resistance. More insulin is then produced, which is where the problem lies: Insulin is a growth hormone that causes one to gain even more weight. The way to break this cycle? Lose the extra weight. Which is why doctors highly recommend healthy eating habits and more exercise to the typical diabetes patient. But what if you need to lose the weight fast or your health could be in grave danger? Or if you are seriously overweight and need to do something about it before diabetes takes over your life? Then it’s time for a diet overhaul where you need to seriously consider cutting down your calories intake to between 800 to 1,200 calories a day. One way to do this is through a total diet replacement (TDR) programme where the patient opts for a total formula liquid 800kcal/d low calorie diet composed of nutritionally complete soups and shakes formulated to provide all the needed vitamins, minerals, essential fats and protein. Take note that TDR is not just about cutting down calories; it is also ensuring that within the small amount of allocated calories, the patient is still getting what is needed for health. A lot of research has gone into TDR and how it affects a diabetic patient, and the results are promising. “Before we can introduce this type of preventive measure, you’ve got to have solid evidence that you are doing the right thing,” says Prof Anthony R Leeds, Visiting Professor at the International Medical University (IMU), Malaysia and the Faculty of Science, University of Copenhagen, Denmark and practices at the Department of Diabetes and Endocrinology, Central Middlesex Hospital, United Kingdom. To further validate TDR as an effective programme for diabetic patients, Prof Leeds studied various research that explores TDR as an effective weight loss to prevent diabetes and to achieve remission in early diabetes. Based on these research, evidence shows that a larger amount of patients who followed TDR experienced significant weight loss (some more than 10kg) and by maintaining the weight loss, three out of four patients actually underwent diabetes remission. On top of that, there was a huge reduction in anti-diabetes and high blood pressure medications for these patients (up to 78%) and more importantly, an improvement in quality of life.

Is TDR for the Malaysian patient?
An important success factor for TDR is the discipline one needs to follow it closely and then maintain the diet. This may prove to be a challenge for the Malaysian patient as a huge part of our culture surrounds food. On top of that, a wide variety of food is available round the clock in our country, so the biggest challenge for a Malaysian diabetic patient is to resist these delicious solid foods and stick to the liquid food of TDR. What patients need to realise is that TDR is not about depriving them of food but helping them make that much-needed drastic change to their weight and ultimately their health before their diabetes becomes worse. “[Patients] tend to think that this type of product is not food. But if you look at the definition of food in terms of what it is, it’s defined as providing energy and micronutrients, so actually, TDR is food,” says Prof Leeds. A suggested TDR sample diet? “It’s pretty straightforward – three servings a day of liquid meals which can be soups or shakes, and fruits in between,” shares Prof Leeds.

Is TDR for the Malaysian patient?

An important success factor for TDR is the discipline one needs to follow it closely and then maintain the diet. This may prove to be a challenge for the Malaysian patient as a huge part of our culture surrounds food. On top of that, a wide variety of food is available round the clock in our country, so the biggest challenge for a Malaysian diabetic patient is to resist these delicious solid foods and stick to the liquid food of TDR. What patients need to realise is that TDR is not about depriving them of food but helping them make that much-needed drastic change to their weight and ultimately their health before their diabetes becomes worse. “[Patients] tend to think that this type of product is not food. But if you look at the definition of food in terms of what it is, it’s defined as providing energy and micronutrients, so actually, TDR is food,” says Prof Leeds. A suggested TDR sample diet? “It’s pretty straightforward – three servings a day of liquid meals which can be soups or shakes, and fruits in between,” shares Prof Leeds.

More than just a diet It’s one thing to follow the TDR diet to take the weight off but another to maintain it after one has achieved the desired weight. Which is why TDR requires a commitment and discipline from the patient, going into it for the long haul. For success rates, Prof Winnie Chee, Dean, School of Health Sciences, International Medical University (IMU) says that TDR “requires very high motivation and is only for selected individuals – those at high risk and are very motivated.” The programme is only for a few months where the patient will strictly follow a liquid-only diet; thereafter; it is important that the patient takes on a maintenance diet of healthy food while still replacing one of two meals with liquid. “It’s all part of the eating healthy concept. You still have to practise your healthy portion control with your other meals when you are maintaining the weight loss after TDR,” adds Prof Chee. Luckily, because the results and health impacts are obvious with TDR, those on the diet are likely to be motivated to continue with the programme. “Essentially, a short-term weight loss which delivers enough weight loss to make a huge difference should be motivating for most people,” says Prof Leeds. Help and support from their doctors as well as family can also further motivate the patient to stick to the maintenance diet, encouraging them to take on a healthier approach to address their diabetic condition.

“Effective Weight Loss with Total Diet Replacement Diet to Prevent Diabetes and to Achieve Remission in Early Diabetes” Talk
Featuring this topic, Prof Anthony R Leed delivered a talk titled “Effective Weight Loss with Total Diet Replacement Diet to Prevent Diabetes and to Achieve Remission in Early Diabetes” on 29 November 2018 at the International Medical University (IMU) campus in Bukit Jalil.