New Australian research shows that low-calorie diets, facilitated in the primary care setting, can put type 2 diabetics into remission.
The independence of new Australian research demonstrating that low-calorie diets can put type 2 diabetes into remission has been called into question.
But Australian Diabetes Society CEO Professor Sof Andrikopoulos says the “salacious” accusations are putting diabetes research in jeopardy when it is already suffering.
“To criticise Australian research which shows that we can help people with type 2 diabetes attain an ultimate goal of remission for a period of time is terribly ill-informed,” said Professor Andrikopoulos.
The University of Sydney’s DiRECT-Aus study, commissioned by Diabetes NSW & ACT, replicated a UK study, labelled “landmark” by Professor Andrikopoulos, that showed that a primary care-led, controlled weight management program using meal replacement shakes resulted in type 2 diabetes remission for some patients.
In the Australian study, participants were put on a low-calorie diet of Nestle Optifast shakes for 13 weeks, followed by structured food reintroduction and a continued maintenance program.
Over half the adults in the study reached type 2 diabetes remission after 12 months.
Diabetes Australia endorsed the low-calorie approach and hoped it would add to the mounting evidence that type 2 diabetes can be put into remission.
“[This] may provide alternative treatment options for people living with type 2 diabetes as well as hope and motivation and a renewed sense of action after a diagnosis of type 2 diabetes,” Diabetes Australia said in reference to the trial.
But recent media has questioned the validity of the research, pointing out that Nestle donated its Optifast shakes to the study and that one of the authors of the paper Professor Tania Markovic, who disclosed the interest in the paper, had previously been on the advisory board of Nestle Health Sciences.
Nestle has since defended its decision to donate shakes to the research, noting that it was approached by Diabetes NSW & ACT and that low-calorie diets are evidence-based interventions.
“Nestle Health Science was not involved in the design or undertaking of the study and had no influence on the research findings,” the company said.
The university also stood behind its research.
“Industry involvement has led to exciting developments across many fields of medical research and rigorous procedures are in place to govern engagement with industry,” a spokesperson for University of Sydney said.
“The conduct of the research and interpretation of the findings are strictly insulated from industry and as per standard practice.
“All relevant disclosures were declared when the paper was submitted for publication and researchers declared any potential conflicts of interest related to the conduct of this research as required by our Research Code of Conduct and the Australian Code for the Responsible Conduct of Research.”
Speaking to The Medical Republic, Professor Andrikopoulos called the recent coverage of the topic by The Australian “salacious reporting” which “misrepresented” the purpose of the research and “put a negative lens on Australian diabetes research”.
According to Professor Andrikopoulos, using a particular company’s shake to achieve the results “wasn’t the purpose of the study”.
“The purpose of the study was to show whether reasonably strong calorie restriction can lead to remission in a primary care setting in Australia,” he said.
“We are all supportive of research that shows that diabetes remission is possible.”
He said the research provided support for adding low-calorie diets to the primary care toolkit for diabetes management, alongside other options.
“There’s a place for low-carb diets [in diabetes management], no doubt about it,” said Professor Andrikopoulos.
“But it’s not the only solution.
“It’s about personalised, individualised care.”
Ten years of research into chronic diseases had shown there was no “one-size-fits-all” solution, he added.
One thing it seems everyone in the diabetes arena can agree on: the state of diabetes funding is in a dire state.
In a recently published LinkedIn piece, Professor Andrikopoulos outlined the “erosion of diabetes funding over the past 10 years (and perhaps even longer)”.
He said the NHMRC’s diabetes research funding had decreased by 35% between 2013 and 2022, and currently sat at $7.6 million to date in 2023 (compared with $27 million to cancer and $26 million to cardiovascular disease).
“More worryingly, the recently announced NHMRC Postgraduate Scholarships (that support early career reseachers) showed that only $380K went to diabetes (3 grants out of 60!) compared with $1.4 million to cancer and 1.4 million to cardiovascular disease.
“The numbers don’t lie – diabetes research in Australia is in a dire state, with many labs closing and many excellent researchers leaving for other better funded disease areas, or going overseas or leaving research altogether.”