Having recently returned from the World Diabetes Conference in Vancouver, where he presented the conclusions of his groundbreaking research into Type Two diabetes, Newcastle University’s Professor Roy Taylor speaks with modesty about his team’s discovery that losing less than one gram of fat in the pancreas can reverse diabetes.
‘It’s probably best to wind back to the beginning,’ he tells me. ‘In 2008 I suddenly saw how diabetes could be explained in very simple terms. I published that as a hypothesis, but you can do anything sitting in an armchair; we had to go out and test this idea. The concept was that if we cut back sharply on what people ate, the diabetes could go away. We tested the hypothesis [in 2011] and we showed that to be true. We showed that the level of fat in the liver went down and the liver response to insulin went to normal. But, importantly, the level of fat in the pancreas went down, and to everyone’s astonishment, the insulin secretion by the pancreas went back to normal.’
Professor Taylor and the Newcastle University research team set about further tests, studying a group of people, some of whom had diabetes, and some of whom didn’t, who lost an equivalent amount of weight. ‘The fat in the pancreas stayed exactly the same in people without diabetes,’ he tells me. ‘You lose weight and fat isn’t lost from the pancreas. But for people with diabetes it [the fat level] starts off a bit higher, and when it comes down to normal, which it did do, then that happens at exactly the same time that the pancreas wakes up and starts functioning normally.
‘So we’ve shown that the excess fat in the pancreas is specific to diabetes and that it’s highly likely to be the cause of this decreased function that is the whole heart and soul of Type Two diabetes. It’s less than one gram of extra fat that’s really gumming up the works. This understanding is a really important simplification because previously there have been all sorts of ideas about what might cause Type Two diabetes but it didn’t really fit together.’
The research team have effectively provided a potential cure for a disease that is threatening to spin out of control in the UK. But the fight is far from over, as Professor Taylor is quick to acknowledge. ‘The average weight in the population is rising very rapidly,’ he explains. ‘Unsurprisingly, incidence of diabetes is rising in step with that. Until we have a change of culture amongst politicians who are willing to tackle food supply and bring in appropriate legislation then we’re not going to see any improvement on the wider front. The problem in the North East is fairly severe.’
The team’s research is only a step (albeit a very important step) in the right direction, and years of hard work, research and testing lie ahead. The next move is to test this idea in comparison with standard practices and methods already employed by the NHS over a two-year period. Funded by Diabetes UK (the largest ever research grant in the charity’s 80-year history) the aim of the study is to compare the long-term health effects of guideline care methods with a low-calorie diet and long-term approach to weight management. A number of GP practices in Scotland and Tyneside will adopt the specific weight loss method of an extreme diet advocated by Professor Taylor and his research collaborator Professor Mike Lean (how appropriate) of the University of Glasgow, and the results will be compared with other practices’ routine approaches.
In some ways it comes down to willpower – those who want to and are capable of losing weight have been able to rid themselves of the disease. But the dangers arrive when offering this new solution to the wider community. ‘We need to look very carefully to see what happens when we try and offer it to a wide range of people,’ Professor Taylor explains. ‘We need to be wary that we’re not advising something that might end up being deleterious to a person. We’ve got to do that very careful work in order to be certain about giving advice. That’s work that’s in progress – hopefully Tyneside will be in the headlines again when eventually we have an answer.’