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• W2783457377 abstract "It is now known that the two pathophysiologic defects in type 2 diabetes, insulin resistance and reduced insulin secretory capacity, can be reversed using acute calorie restriction. Understanding the mechanisms determining normalization of blood glucose levels and the limitations to reversal of diabetes by very low–calorie diet (VLCD) or bariatric surgery has important implications for the treatment of type 2 diabetes. A unifying hypothesis to explain the major pathophysiologic defects in type 2 diabetes involves excess fat accumulation in the liver and pancreas. Within 7 days of a VLCD, fasting plasma glucose levels can be normalized and liver fat content falls substantially. The clinical characteristics that seem to limit the reversal of diabetes are discussed, specifically the effect of longer duration diabetes. It appears that normalization of fasting glucose levels can be achieved in those with a diabetes duration of more than 8 years, and that baseline insulin secretory capacity and recovery of this after calorie restriction are key in determining the glucose response to a VLCD. Weight regain after a VLCD can be avoided using a structured, individualized weight maintenance program. With maintenance of weight loss, the beneficial effects of an 8-week VLCD (on glucose levels, liver fat content, lipid profile, and blood pressure) can be continued for at least 6 months. The practical aspects of the use of VLCDs in type 2 diabetes and subsequent avoidance of weight regain are discussed." @default.
• W2783457377 created "2018-01-26" @default.
• W2783457377 creator A5003141744 @default.
• W2783457377 date "2018-01-01" @default.
• W2783457377 modified "2023-09-24" @default.
• W2783457377 title "New Approach to Type 2 Diabetes Reversal in Obesity" @default.
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• W2783457377 doi "https://doi.org/10.1016/b978-0-323-48559-3.00024-5" @default.
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