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 studied 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 have undergone 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 were supported to gradually return to normal eating and weight loss maintenance for six weeks. Participants completed this eight-week cycle up to three times. After each cycle, the research team measured 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