Reversing Type 2 Diabetes in the Caribbean: Preliminary findings from a feasibility study in Barbados

OBJECTIVE: In a high proportion of persons recently diagnosed with Type 2 diabetes, a short (2–3 months) very low calorie diet is able to restore normal glucose and insulin metabolism. The objective of this study is to determine the feasibility of this approach in Barbados. SUBJECTS AND METHODS: Twenty-five individuals aged 20to 69 years with Type 2 diabetes diagnosed within the past six years, not on insulin, and body mass index (BMI) > 27kg.m-2 were recruited. Hypoglycaemic medication was stopped on commencement of the eight-week liquid (760calorie) diet, during which participants were assessed weekly. Findings from the liquid diet phase and the following three months are presented. RESULTS: The study participants comprised 10 men and 15women (mean age 48 years, range 26–68 years). Mean(SD, range) BMI was 34.2 kg.m-2 (6.0, 27.0–52.8) and fasting plasma glucose (FPG) was 9.2 mmol.l-1 (2.2, 6.7–14.6). Over the eight-week intervention, mean weight loss was 10.1 kg (4.7, 1.5–20.8) and waist circumference loss10.9 cm (4.0, 5.1–20.8). Fasting plasma glucose fell by 2.2mmol.l-1 (range 1.5–7.9). At eight weeks, FPG was < 7mmol.l-1, the diagnostic cut point for diabetes, in 15 participants compared to three at baseline (p = 0.004). At three months post liquid diet, 17 had FPG < 7 mmol.l-1 (still off medication). CONCLUSION: There was substantial weight loss and fall inFPG in the majority of participants, sustained at three months follow-up. Data on changes in pancreatic function are being analysed. These findings will inform a larger, pragmatic, multi-centre Caribbean trial.