For some time there have been claims that not only can type 2 diabetes be controlled by diet, but it can also be reversed, effectively curing the disease. Researchers at Yale University have now uncovered key mechanisms that could explain how a very low calorie diet can reverse type 2 diabetes, opening up new targets for drug treatments.

Many are calling the worldwide increase in the prevalence of type 2 diabetes a global epidemic. Currently, hundreds of millions of people around the globe suffer from the condition, and one projection estimates that by 2050 one in three Americans will develop the disease.

For many early type 2 diabetes diagnoses, doctors say the condition can be controlled with diet but some recent studies have suggested that following a very low calorie diet (600 to 800 calories a day), for eight weeks, can actually reverse the disease altogether. Often with small sample sizes, these studies tended to result in hyperbolic news headlines and any underlying mechanism behind these results remained unexplained.

Now a Yale team has shed light on how such an extreme diet could move the disease into remission. In a study using a rodent model, the team identified three primary mechanisms that seem to be responsible for lowering blood glucose concentrations during a very low calorie diet.

Focusing on the key metabolic processes centered in the liver, the restricted diet was seen to reduce the organ's glucose production. The conversion of lactate and amino acids into glucose was decreased, as was the rate of liver glycogen converting into glucose. The diet also reduced the liver's fat content, which was seen to enhance the liver's response to insulin.

These mechanisms were observed just three days into the animal's diet, showing an impressively fast response, and reversal, of hyperglycemic conditions. Human tests are set to follow and the researcher's believe this could pave the way for new drug treatments for the condition.

"These results, if confirmed in humans, will provide us with novel drug targets to more effectively treat patients with type 2 diabetes," says senior author Gerald Shulman.

The study was published in the journal Cell Metabolism.