Every year we invest over £6 million into pioneering diabetes research. Let’s take a closer look at a project that’s exploring how supporting teenagers with type 2 diabetes with a low-calorie diet programme could help them to go in to remission.
Dr Pooja Sachdev is a Consultant in Paediatric Diabetes and Endocrinology at Nottingham Children’s Hospital. With our funding, she’s working with children and young people with type 2 diabetes to understand how they feel about low-calorie diets to help them lose weight.
Our DiRECT study has transformed our understanding of type 2 diabetes. It showed that adults with type 2 who live with obesity or overweight can put their diabetes into remission through a low-calorie diet weight-management programme. But we don’t know if children with type 2 diabetes could benefit from a similar treatment.
We asked Dr Sachdev about her journey into diabetes research:
“Having grown up in India, where type 2 diabetes is particularly common, I’ve seen first-hand the impact of a diagnosis of diabetes in several family members. For them, this almost always seemed to mark the start of lifelong illness, and fear of complications. With increasing numbers of young people being diagnosed with this condition and research showing that it is even more aggressive in this age group, it’s become even more important to advise families and young people, and help them get the support they need.”
A LEGENDary study supporting teenagers with type 2 diabetes
Studies have shown that low-calorie diets can help children and young people living with obesity lose around 10kg. But there’s been very little research looking at the effects of weight loss on remission in children living with type 2 and obesity.
Dr Sachdev said:
“Young people with type 2 diabetes are at a higher risk of developing diabetes-related complications during the most crucial years of their lives. Early and effective intervention can result in more years living well, and significant savings to the NHS.”
Before costly and timely clinical trials are run to test the effectiveness of weight loss in young people with type 2, scientists need to know if they would want to take part in a low-calorie diet study.
This is where Dr Sachdev comes in. She said:
“We learned that the work by the DiRECT team was resulting in a shift in how type 2 diabetes is viewed in the adult world. The idea that it’s ‘no longer necessarily a lifelong condition’ got our team thinking about the possibility of this approach in young people. So, we started offering a short period of total diet replacement products to some young people living with obesity and type 2 diabetes that were motivated to try this.”
Dr Sachdev’s project, the LEGEND (‘Low EnerGy DiEt iN adolescents with type 2 diabetes and obesity’) study, involves 33 children aged 12-18 years with type 2 diabetes. They’ll be given a low-calorie diet for 12 weeks, with frequent support from their healthcare team. After this, they’ll gradually reintroduce normal meals and healthy eating under the careful guidance of a dietitian.
During the study, the children will have regular tests and scans to monitor their health and check for remission. This will give researchers a vital first insight into how much weight children and young people need to lose to see benefits like those in adults.
Dr Sachdev and her team will also talk to the children and their families, as well as healthcare staff, to find out what makes it easier or harder for children to take part in this type of study and stick to a low-calorie diet for the whole 12 weeks.
Dr Sachdev said:
“On one hand, young people haven’t lived with type 2 diabetes for as long, making remission more likely. But on the other hand, their condition is more aggressive, which could make putting their diabetes into remission more difficult. Therefore, exploring the impact of rapid, significant weight loss in young people with type 2 diabetes is crucial and the first step is understanding how easy this approach is for this age group.”
A future in remission
The number of young people diagnosed with type 2 diabetes in the UK and rates of childhood obesity are increasing steeply year on year. Young people with type 2 have the fewest treatment options and the highest risk of diabetes complications. So we asked Dr Sachdev about some of her most crucial priorities to address this:
“If a low-calorie approach is acceptable to young people and they’re able to stick to it in the short term, our plan would be to test this approach in larger numbers. As well as young people diagnosed with type 2 diabetes, we’d also recruit those at high risk of the condition. We need to understand which young people may benefit from a low-calorie diet, and the factors that make this easier or harder.”
Dr Sachdev’s research could lead to a new urgently needed treatment for young people with type 2 and provide them with hope for a healthier future, free from type 2 diabetes and its complications.
“I would hope that a multi-prong approach of prevention will mean that fewer young people will develop type 2 diabetes and those that do have a better chance of going into remission.”
Outside of the lab
Fuelled by big mugs of tea, Dr Sachdev enjoys reading, swimming, going to the theatre, and travelling during her spare time. She also has a keen interest in hypnotherapy and has been known to practice her skills on family and friends.
However, none of the research we fund would be possible without the generosity of our supporters, who help Dr Sachdev and her colleagues to work to change the lives of people with diabetes.
“I’d like to express my gratitude to all those who support the fantastic work funded by Diabetes UK, and I look forward to coming back to talk about our results over the next few years.”