Reversal of Type 2 diabetes Upon Normalisation of Energy intake in the non-obese (ReTune)

OVERVIEW

Obesity is a key risk factor for type 2 diabetes, but not everyone with this condition is overweight. The cause of type 2 diabetes in non-obese people was thought to be different from in obese people, but results of experiments do not support this view. An alternative idea is that people have a personal level of total body fat that they can tolerate and if they go above that level, they develop diabetes. Re-TUNE will study whether weight loss in people with type 2 diabetes who are not obese can reverse their condition, which would support the idea of a personal fat threshold.

DESIGN

In this Newcastle-based study, funded by Diabetes UK participants will undergo stepwise weight loss under medical supervision by consuming a low-calorie diet (800 calories a day from soups, shakes and non-starchy vegetables) for up to two weeks. After this, they will be supported to gradually return to normal eating and weight loss maintenance for six weeks. Participants will complete this eight-week cycle up to three times. After each cycle, the research team will measure levels of insulin and the amount of fat in the pancreas and liver.

AIMS

Primary

• To determine whether weight loss can reverse type 2 diabetes in non-obese people, and to identify at which Personal Fat Threshold, people achieve diabetes remission.

Secondary

• To find out which blood tests (biomarkers) might indicate an individual’s Personal Fat Threshold
• To find out why diabetes develops in non-obese people by gaining more information about the pancreas and liver
• To develop a Diet Decision Aid to help people decide which eating pattern to follow for long-term maintenance of the weight loss

RESULTS