Registered CDE-Optifast® Dietician
Did you know type 2 diabetes can be put into remission?
Diabetes cannot be cured, because the pancreas cells are permanently damaged, but insulin resistance can be reduced, while type 2-diabetes can be put into remission.
What is the CDE-Optifast® Programme?
The CDE-Optifast® Programme is nutritionally structured and developed by leading experts and supported by medical professionals.
Before registration you need to be medically assessed by a general practitioner to rule out health risks, while laboratory tests may also be required. You will nutritionally be assessed by a CDE Optifast® registered dietician, while follow-up visits will be scheduled for week 2, week 4 and week 8 as well as on 6 months. During the monitoring period you will not only learn how to lose weight but also how to keep it off.
The CDE-Optifast® programme is a very low caloric (800 kcal) dietary programme. To ensure safe weight loss adequate protein, fat and carbohydrates as well as vitamins and minerals are provided daily. It consists of three scientific formulated shakes taken daily for a period of eight weeks. This is accompanied by unrestricted vegetable and salad intake. The eight week period is followed by a four week period where food is gradually re-introduced. Initially, your intake will consists of one caloric controlled meal together with two shakes. This is followed by one shake and two low caloric controlled meals for the remaining two weeks.
According to the literature consumption of Optifast® promotes significant weight loss; an average of 1 - 2.5 kg is lost per week. After being on the CDE-Optifast® programme for 26 weeks, the study group lost an average of 25% of their starting weight.
Recent research indicated that 87% of people who have had diabetes for less than four years can achieve diabetes remission after 8 weeks on the CDE-Optifast® programme. However, if you have diabetes for longer than 8 years, one has a 50% chance to achieve remission if you follow the low caloric dietary programme. If remission doesn’t occur all is not lost, because you have lost weight while improved blood glucose levels will be experienced. Another advantage is that less insulin and oral medication will also be used.
Remission of Type 2 diabetes
Approximately 400 million people worldwide are diagnosed with Type 2 diabetes. In the past, more focus was put on the progressive nature of the disease. However, on a more positive note, Dambha-Miller et al. (2019) reported that Type 2 diabetes can enter remission.
Remission of diabetes is classified as an HbA1c of <6.5% without any pharmacological or surgical interventions. This can be achieved by significant energy restriction, resulting in a weight loss of approximately 10% body weight. It is recommended to lose this weight within the first five years after diabetes is diagnosed.
This rationale may motivate individuals when more realistic weight goals are set in collaboration with the assistance of a dietician, instead of focusing on unachievable high weight targets, which could be detrimental to success.
Reference
H. Dambha-Miller, Day, A.J., Strelitz, J., Irving, G. & Griffin, S.J. 2019. Behaviour change, weight loss and remission of Type 2 diabetes: a community based prospective cohort study. Diabetic Medicine. 00:1-8.
Remission of Type 2 diabetes
Approximately 400 million people worldwide are diagnosed with Type 2 diabetes. In the past, more focus was put on the progressive nature of the disease. However, on a more positive note, Dambha-Miller et al. (2019) reported that Type 2 diabetes can enter remission.
Remission of diabetes is classified as an HbA1c of <6.5% without any pharmacological or surgical interventions. This can be achieved by significant energy restriction, resulting in a weight loss of approximately 10% body weight. It is recommended to lose this weight within the first five years after diabetes is diagnosed.
This rationale may motivate individuals when more realistic weight goals are set in collaboration with the assistance of a dietician, instead of focusing on unachievable high weight targets, which could be detrimental to success.
Reference
H. Dambha-Miller, Day, A.J., Strelitz, J., Irving, G. & Griffin, S.J. 2019. Behaviour change, weight loss and remission of Type 2 diabetes: a community based prospective cohort study. Diabetic Medicine. 00:1-8.
Very low calorie diets in the management of type 2 diabetes mellitus
A study was conducted by Van Wyk and Daniels (2016) amongst 11 people with type 2 diabetes on an outpatient basis. A very low-calorie diet (VLCD), consisting of three food replacement shakes and unrestricted quantities of non-starchy vegetables (<800 kcal), was followed. After two weeks, one shake was replaced with a solid meal consisting of lean protein and vegetables without specific calorie restriction. During the fourth week, only one meal replacement shake was used.
Patients experienced a mean weight loss of -4.39 kg, decreased waist circumference (-4.32 cm), and lower body mass index (-1.4 kg/m2).
For a period of three days, the mean fasting blood glucose before lunch and supper decreased by -3.07, -3.65, and -2.9 mmol/l, respectively. Due to these positive results, hypoglycaemic and insulin treatment were reduced.
The fasting blood glucose of individuals dependent on insulin was 10.75, 12.55, and 10.30. When the VLCD diet was followed for 4 weeks, the mean fasting decreased to 7.5, 7.3, and 6.98 mmol/l. These positive results occurred despite having diabetes for 15 years. The mean total daily insulin dosage also reduced from 121 to 69 units.
In general, most individuals were satiated with the use of a mean meal replacement. However, some reported taste fatigue, bloating, cramping, and flatulence, which may be due to the prevalence of sugar alcohols.
Van Wyk and Daniels concluded that less oral hypoglycaemic treatment, especially gliclazide, is required after following the VLCD. People dependent on insulin also require less insulin.
Reference
Van Wyk, H. & Daniels, M. 2016. Case Discussion: The use of very low calorie diets in the management of type 2 diabetes. South African Journal of Clinical Nutrition. 29(2):96-102.