Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Mostly false Overinterpreted Certainty of evidence: moderate provisional C-DIAB-03

Diabetes can be cured by following the Tayebat system without medication, illustrated by a patient who stopped insulin after 30 years of insulin use.

Safety note: Do not stop or reduce insulin on the basis of this claim. In type 1 diabetes and other insulin-deficient states, stopping insulin leads within hours to days to diabetic ketoacidosis, which is life-threatening. Medically accepted position (ADA Standards of Care 2026): insulin treatment is essential for people with type 1 diabetes; people on intensive insulin therapy should not stop basal insulin even when not eating. Any change of diabetes medication should be made together with the treating physician.
In short: This claim is mostly false. Substantial weight loss can put early type 2 diabetes into remission in many people, but this is remission rather than cure, it fades in many, and it does not apply to type 1 diabetes or to most long-standing insulin-treated diabetes; the Tayebat system itself has never been tested.
Conclusion: Early type 2 diabetes can go into remission with substantial, supervised weight loss, but this is not a cure and does not apply to type 1 or most long-standing insulin-treated diabetes; the claim that the Tayebat system cures diabetes is not supported.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

جالي عيان راجل من تونس والراجل ده من بقىه 30 سنه بياخد انسولين بطل الانسولين من اربع شهور مشي على النظام شهرين بقى كويس

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Diabetes can be cured by following the Tayebat system without medication, illustrated by a patient who stopped insulin after 30 years of insulin use.

Origin

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live! السيليوليت (Open source)
Published
11 October 2025
Timestamp
0:53:37 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.
Claimed mechanism

Removing harmful foods resolves the stress that raises glucose.

Claimed health effect

Diabetes cure

Population concerned

People with diabetes

Geographic restriction by Elawady

none found

Diverging source versions

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live! مفيش حاجه سعرات مفيش حاجه اسمها نشويات (Open source)
Published
7 August 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); no timestamps; 'published' is the date listed by the archive and may be the upload date. Live-stream transcripts can contain viewer comments read aloud; the quoted passage was checked in context to be spoken by Elawady.

Scientific assessment

Mostly false – Essential parts of the statement are not supported by the evidence or are strongly exaggerated.

Certainty of evidence: moderate – Further research may still affect the assessment.

1. What was claimed?

Diet cures diabetes, as shown by patients who stopped insulin on the system.

2. What is demonstrably correct?

DiRECT: remission (HbA1c <6.5% off all drugs) in 46% vs 4% at 12 months; 86% of those losing >=15 kg (I-FAST-12); 36% vs 3% at 24 months (I-FAST-13). DIADEM-I (Qatar, people from the Middle East and North Africa, diabetes <=3 years): remission 61% vs 12% after an intensive diet programme (I-DIAB-101). A meta-analysis of 18 nonsurgical RCTs found remission about six times more likely with nonpharmacological programmes (RR 5.80) (I-DIAB-103). ADA 2026 states that sustained loss of >10% body weight may lead to remission (I-DIAB-113). The archive itself recommends diet and weight loss before insulin escalation (C-INS-11).

3. What is wrong or exaggerated?

Remission trials used structured low-energy programmes with medical supervision and enrolled mainly people with recent, non-insulin-treated type 2 diabetes; remission depended on weight loss, not on avoiding particular 'forbidden' foods (I-FAST-12, I-DIAB-101, I-DIAB-103). Remission mostly waned: at 5 years 10% vs 5% of the original DiRECT groups were in remission (I-FAST-14); in Look AHEAD only 3.5% stayed in remission for 4 years (I-DIAB-102). The accepted term is remission, not cure, and it requires continued follow-up (I-DIAB-104). Before insulin existed, diet and fasting could not keep insulin-deficient diabetes alive: most children died of diabetic coma within months to years and Allen wrote that 'the diabetes is not cured' (I-INS-101). Type 1 diabetes cannot be cured by diet (C-INS-07). The Tayebat system has not been tested; the cases cited are not verifiable.

4. What remains unclear?

Whether the Tayebat dietary rules produce sufficient weight loss in practice.

5. Which studies support it?

I-FAST-12, I-FAST-13, I-DIAB-101, I-DIAB-103, I-DIAB-113 (remission of early type 2 diabetes with major weight loss); partly I-FAST-14, I-DIAB-102, I-DIAB-104 (some long-term remission; definition).

6. Which studies contradict it?

I-INS-101 (pre-insulin natural history), I-INS-03, I-ODD-16; I-FAST-14 and I-DIAB-102 (remission mostly not durable; people on insulin largely not studied).

7. What applies to Germany and Europe?

German guidance accepts remission through weight reduction as a goal in early type 2 diabetes.

8. What is known about Egypt?

Lifestyle-based remission programs are less established; supervision is needed when reducing drugs.

9. What practical conclusion is appropriate?

Early type 2 diabetes can go into remission with substantial weight loss under medical supervision; medicines are reduced step by step with monitoring. This does not apply to type 1 diabetes.

Assessment details

Rationale for certainty of evidence

Split: (a) remission of early type 2 diabetes through substantial weight loss is shown in RCTs (DiRECT 46% vs 4%; DIADEM-I in a Middle Eastern population 61% vs 12%) and a 2025 meta-analysis of 18 RCTs (I-DIAB-103), but mostly in people with short diabetes duration, without insulin, under strict supervised protocols, and remission often fades (I-FAST-14, I-DIAB-102). (b) Cure of type 1 diabetes or long-standing insulin-deficient diabetes by diet is contradicted by natural-history data from the pre-insulin era (I-INS-101) and by all guidelines. (c) The Tayebat system has not been tested. Certainty is moderate (raised from low): the boundaries of diet-induced remission are now well defined by randomised evidence; the only indirectness is that the specific system is untested.

Source quality

Own words; anecdotal cases.

Regional transferability

DiRECT conducted in UK primary care; transferability to Egypt plausible if weight loss is achieved.

Individual exceptions

Remission is most likely with short diabetes duration (<6 years), no insulin, and large sustained weight loss (>10-15 kg).

Regional scope of the claim
general (biological/medical)
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

Overinterpreted – A real finding exists, but the claim draws more from it than the data allow (e.g. association taken as cause, animal data applied to humans, small effect presented as large).

Research question: Can diabetes, including long-standing insulin-treated diabetes, be cured by a diet without medication?

Research question in detail (PICO)
Population
People with type 1 diabetes, long-standing insulin-treated diabetes and early type 2 diabetes
Intervention or exposure
Dietary/lifestyle programmes (including the Tayebat system)
Comparison
Usual care with medication
Geographic scope
universal biology; Middle East data available (DIADEM-I)
Outcomes
  • Remission (HbA1c <6.5% off drugs >=3 months)
  • Durability
  • DKA and harm when insulin is stopped

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

Early type 2 diabetes can go into remission (not cure) with substantial supervised weight loss; type 1 diabetes and long-standing insulin-deficient diabetes cannot be cured by diet; the Tayebat system has not been tested.

Why some studies weigh more

RCTs define the boundaries of remission (early T2D, weight loss, supervision); historical and guideline evidence define the impossibility for insulin-deficient diabetes; anecdotes carry no weight.

Is a causal relationship established? Yes, established Weight loss causes remission in early T2D (RCTs with dose-response); absence of insulin causes death in insulin-deficient diabetes (historical natural history).

Remaining uncertainty

Long-term durability; effect of the specific Tayebat rules (untested); the illustrative patient's diabetes type is unknown.

Justified conclusion

Mostly false; true only for remission of early type 2 diabetes via weight loss.

Why do studies seem to disagree?

Remission trials (supporting) and historical/guideline evidence (contradicting) concern different populations: early T2D with preserved beta-cell function versus insulin-deficient diabetes. Ketosis-prone T2D (I-INS-128) shows that some people who present with DKA can stop insulin, but only under supervision and based on phenotype.

Does this depend on the country?
General biological effects
Insulin physiology, autoimmune type 1 diabetes and ketoacidosis are universal human biology.
Eating habits
DIADEM-I shows remission is achievable in people from the Middle East and North Africa with structured weight loss.
Origin of the food
Not relevant.
Contaminants
Not relevant.
National production conditions
Not relevant.
Legal rules
Insulin is an essential medicine (WHO list) in Egypt and the EU; prescription rules not relevant to the scientific question.
Actual monitoring data
Egyptian/Middle Eastern data show severe DKA is common at presentation in children (I-INS-115, I-INS-114); no data on outcomes among Tayebat followers.

A regional difference that changes the conclusion is not supported by robust data.

Statistical re-check
  • Absolute remission difference and NNT – 49 percentage points (35.5-62.5); NNT about 2; OR 12.03 overstates the relative effect (RR about 5.1) recalculated
  • Absolute remission difference – Year 1: 9.5 points (NNT about 10.5); year 4: 5.3 points (NNT about 19) recalculated
  • Absolute remission difference – 42 points (33.4-50.6); NNT about 2.4 recalculated
Certainty of the overall evidence (GRADE, simplified)
Main outcome
Remission of diabetes off medication with dietary intervention (claim as stated, incl. insulin-treated/type 1)
Starting level
high (randomised trials)
Reasons for downgrading
  • indirectness (Tayebat system untested; trials in early T2D only)
Result
moderate

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Clinical guidelines and official statements checked
  • ADA: 8. Obesity and Weight Management: Standards of Care in Diabetes-2026 (2026) · Original publication
    Sustained loss of >10% body weight may lead to remission of type 2 diabetes (A); weight loss reduces the need for glucose-lowering drugs, particularly insulin.
  • ADA: 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2026 (I-ODD-16) (2026) · Original publication
    'Insulin treatment is essential for individuals with type 1 diabetes'; insulin to be considered in T2D when A1C >10%, glucose >=300 mg/dL or catabolic features (as recorded for I-ODD-16).
  • NICE: NG28 Type 2 diabetes in adults: management (last updated 18 February 2026) (2026) · Original publication
    Low-energy and very-low-energy diets via the NHS Type 2 Diabetes Path to Remission Programme (1.3.4); evidence on stopping/switching medicines is limited (research recommendation).
  • ADA/EASD/Endocrine Society/Diabetes UK: Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetes (PMID 34462270) (2021) · Original publication
    Remission = HbA1c <6.5% at least 3 months after stopping glucose-lowering drugs; continued observation recommended (abstract).
  • ADA/EASD: The management of type 1 diabetes in adults: updated 2026 consensus report (2026) · Original publication
    'Lifelong insulin therapy is essential in type 1 diabetes'; all individuals need glucose and ketone testing supplies; insulin omission or under-dosing is a DKA precipitant.
Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
PubMed26 October 2026Taheri S[au] AND DIADEM-Isupporting evidence4
Europe PMC26 October 2026(TITLE:"remission") AND "type 2 diabetes" AND (TITLE:"meta-analysis" OR TITLE:"systematic review") AND PUB_YEAR:[2021 TO 2026]supporting evidence40
Europe PMC26 October 2026"type 2 diabetes" AND remission AND (Egypt OR Egyptian OR Saudi OR Arab OR "Middle East") AND (diet OR lifestyle) AND (randomized OR randomised)supporting evidence1131
PubMed26 October 2026("type 1 diabetes") AND (diet OR "low-carbohydrate" OR "ketogenic") AND ("insulin independence" OR "stop insulin" OR "discontinue insulin" OR cure)supporting evidence23
Europe PMC26 October 2026("diabetes" AND ("cured" OR "cure") AND (diet OR "dietary") AND (TITLE:"insulin")) AND PUB_YEAR:[2015 TO 2026]supporting evidence289
PubMed26 October 2026("type 2 diabetes" AND remission) AND (insulin-treated OR "insulin therapy" OR "on insulin") AND (diet OR "low-calorie" OR "low-carbohydrate" OR "weight loss") AND (trial OR cohort)both directions20
PubMed26 October 2026Gregg EW[au] AND remission AND "Look AHEAD" AND JAMA[ta]contradicting evidence1
Europe PMC26 October 2026(TITLE:"starvation" OR TITLE:"Allen") AND (TITLE:"diabetes") AND (TITLE:"insulin" OR TITLE:"pre-insulin")contradicting evidence24
PubMed26 October 2026"ketosis-prone" AND (insulin discontinuation OR "insulin independence" OR remission)both directions56
PubMed26 October 2026Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetesguidelines8
PMC (publisher full text)26 October 2026Fetched ADA Standards of Care 2026 sections 2, 6, 8, 10, 14, 16 at pmc.ncbi.nlm.nih.gov/articles/PMC12690183, PMC12690178, PMC12690172, PMC12690187, PMC12690182, PMC12690180guidelines6
Guideline websites (NICE)26 October 2026Fetched https://www.nice.org.uk/guidance/ng28/chapter/Dietary-advice-and-interventions (+ Insulin-based-treatments, Individualised-care)guidelines3

How deeply was this checked?

12 linked studies: 5 checked in full text (1 of them with a structured risk-of-bias assessment), 7 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: Mostly false (low)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Verdict changed: Mostly false (low) → Mostly false (moderate)
    Verdict unchanged. Certainty raised from low to moderate: a 2025 meta-analysis of 18 RCTs and the Middle Eastern DIADEM-I trial define clearly that remission is limited to early type 2 diabetes with major weight loss, while historical natural-history data show that diet cannot replace insulin in insulin-deficient diabetes. The only remaining indirectness is that the Tayebat system itself is untested.
    New sources: I-DIAB-101 I-DIAB-102 I-DIAB-103 I-DIAB-104 I-DIAB-113 I-INS-101 I-INS-128

In plain language

Trials in Britain and Qatar showed that about half or more of people with recently diagnosed type 2 diabetes who lost a lot of weight on a structured programme could stop all diabetes medicines for at least a year. Many relapsed in later years. This worked through weight loss and under medical supervision. Before insulin was discovered, diet alone could not keep children with type 1 diabetes alive. The specific Tayebat diet has never been tested.

Studies on this claim

Studies supporting the claim (5)

  • DiRECT: weight loss to put type 2 diabetes into remission

    Lean ME et al.. Lancet 2018 · PMID 29221645 · DOI 10.1016/S0140-6736(17)33102-1
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    46% of people in the programme were free of diabetes and medication after one year.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Can intensive weight management in primary care achieve T2D remission?

    How was the study done?

    Open-label cluster-randomised trial (DiRECT)

    How many people, animals or samples were studied?

    306 (149 per group ITT); 49 practices; Age 20-65, T2D <6 years, BMI 27-45, not on insulin

    What was actually found?

    Remission 46% vs 4%.

    How large was the observed effect?

    OR 19.7

    What do the results mean in everyday life?

    Losing 10-15 kg can reverse early type 2 diabetes.

    What are the study's limitations?

    Open-label; Selected population; Formula diet

    What does it say about Elawady's specific claim?

    Supports C-DIAB-03 (with conditions); limited relevance to C-INS-10 (insulin users excluded).

    Do the results apply to Germany and Europe?

    UK; directly relevant.

    What can explicitly not be concluded from this study?

    Effect of the Tayebat diet; effect in type 1 or insulin-treated diabetes.

    Scientific details →

  • DiRECT after two years

    Lean MEJ et al.. Lancet Diabetes Endocrinol 2019 · PMID 30852132 · DOI 10.1016/S2213-8587(19)30068-3
    Randomised controlled trialindependent cross-checkabstract checked

    36% were still in remission after two years.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Durability of remission at 24 months

    How was the study done?

    Cluster-randomised trial, 2-year results (DiRECT)

    How many people, animals or samples were studied?

    298 ITT; As DiRECT

    What was actually found?

    Remission 36% vs 3%.

    How large was the observed effect?

    aOR 25.82

    What do the results mean in everyday life?

    Sustained weight loss keeps diabetes away.

    What are the study's limitations?

    Open-label

    What does it say about Elawady's specific claim?

    Supports C-DIAB-03.

    Do the results apply to Germany and Europe?

    UK.

    What can explicitly not be concluded from this study?

    Long-term outcomes.

    Scientific details →

  • Weight-loss programme puts early type 2 diabetes into remission in Qatar

    Taheri S et al.. Lancet Diabetes Endocrinol 2020 · PMID 32445735 · DOI 10.1016/S2213-8587(20)30117-0
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    61% of young adults with recent type 2 diabetes reached remission after an intensive diet programme, versus 12% with usual care.

    Remission 61% vs 12% in early T2D (MENA population) with structured weight loss.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Test intensive lifestyle therapy for early T2D in the MENA region.

    How was the study done?

    Randomised trial.

    How many people, animals or samples were studied?

    158 adults, diabetes <=3 years.

    What was actually found?

    Weight -12 kg; remission 61% vs 12%.

    How large was the observed effect?

    Difference 49 points; NNT about 2.

    What do the results mean in everyday life?

    Early type 2 diabetes can go into remission with major weight loss under supervision.

    What are the study's limitations?

    12 months; open label; no insulin users.

    What does it say about Elawady's specific claim?

    Supports the kernel for early T2D only.

    Do the results apply to Germany and Europe?

    Matches UK DiRECT.

    What can explicitly not be concluded from this study?

    Cannot support stopping insulin or curing T1D.

    Scientific details →

  • Can type 2 diabetes go into remission without surgery? A review of trials

    Sherifali DT et al.. Diabetes Care 2025 · PMID 40982327 · DOI 10.2337/dc25-0562
    Meta-analysisindependent cross-checkfull text checked★ key study

    Structured diet and lifestyle programmes made remission about six times more likely, mainly in people with recently diagnosed type 2 diabetes.

    Remission RR 5.80 for nonpharmacological interventions, mainly early, insulin-naive T2D.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Pool RCTs of nonsurgical remission.

    How was the study done?

    Meta-analysis of 18 RCTs.

    How many people, animals or samples were studied?

    11 countries.

    What was actually found?

    RR 5.80 (nonpharmacological).

    How large was the observed effect?

    RR 1.75-5.80.

    What do the results mean in everyday life?

    Early type 2 diabetes can go into remission with strict programmes.

    What are the study's limitations?

    Heterogeneity; short follow-up.

    What does it say about Elawady's specific claim?

    Supports the T2D kernel, not cure of T1D or long-standing insulin-treated diabetes.

    Do the results apply to Germany and Europe?

    Applicable.

    What can explicitly not be concluded from this study?

    Cannot show permanent cure.

    Scientific details →

  • US diabetes standards 2026: weight loss and type 2 diabetes

    American Diabetes Association Professional Practice Committee for Diabetes. Diabetes Care 2026 · PMID 41358882 · DOI 10.2337/dc26-S008
    Guideline / position statementindependent cross-checkfull text checked★ key study

    Losing more than 10% of body weight can lead to remission of type 2 diabetes and reduce the need for insulin.

    >10% weight loss may lead to T2D remission (grade A).

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Guide weight management.

    How was the study done?

    Guideline.

    How many people, animals or samples were studied?

    Not applicable.

    What was actually found?

    Weight loss >10% may induce remission.

    How large was the observed effect?

    Not applicable.

    What do the results mean in everyday life?

    Weight loss is a powerful treatment for type 2 diabetes.

    What are the study's limitations?

    Guideline.

    What does it say about Elawady's specific claim?

    Supports the T2D kernel of C-DIAB-03.

    Do the results apply to Germany and Europe?

    European guidance agrees.

    What can explicitly not be concluded from this study?

    Not applicable to T1D.

    Scientific details →

Studies contradicting or limiting the claim (3)

  • DCCT: better insulin treatment in type 1 diabetes

    Diabetes Control and Complications Trial Research Group; Nathan DM et al.. N Engl J Med 1993 · PMID 8366922 · DOI 10.1056/NEJM199309303291401
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    Intensive insulin cut the risk of eye damage by three-quarters and nerve damage by 60%, with more low-sugar episodes.

    Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Does intensive insulin therapy reduce long-term complications in type 1 diabetes?

    How was the study done?

    Multicentre RCT (DCCT)

    How many people, animals or samples were studied?

    1,441; Insulin-dependent (type 1) diabetes

    What was actually found?

    Large reductions in all microvascular complications.

    How large was the observed effect?

    Retinopathy -76%

    What do the results mean in everyday life?

    Insulin protects eyes, kidneys and nerves in type 1 diabetes.

    What are the study's limitations?

    Open-label; Selected young population

    What does it say about Elawady's specific claim?

    Contradicts C-INS-07, C-INS-09, C-DIAB-01; shows insulin efficacy and hypoglycaemia cost (C-INS-02 kernel).

    Do the results apply to Germany and Europe?

    North American; universally accepted.

    What can explicitly not be concluded from this study?

    Effects in type 2 diabetes directly.

    Scientific details →

  • ADA guideline 2026: diabetes medicines

    American Diabetes Association Professional Practice Committee for Diabetes*. Diabetes Care 2026 · PMID 41358900 · DOI 10.2337/dc26-S009
    Guideline / position statementindependent cross-checkfull text checked★ key study

    Insulin is essential in type 1 diabetes; SGLT2/GLP-1 drugs are recommended for heart and kidney protection; side effects listed.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Pharmacologic glycaemic treatment

    How was the study done?

    Clinical practice guideline (ADA Standards of Care 2026, Section 9)

    How many people, animals or samples were studied?

    not applicable; People with type 1 and type 2 diabetes

    What was actually found?

    See results.

    How large was the observed effect?

    not applicable

    What do the results mean in everyday life?

    Medicines chosen by benefit-risk.

    What are the study's limitations?

    Partially read

    What does it say about Elawady's specific claim?

    Contradicts C-INS-07, C-INS-10, C-ODD-06; supports C-ODD-07, C-INS-11.

    Do the results apply to Germany and Europe?

    Consistent with ADA/EASD consensus.

    What can explicitly not be concluded from this study?

    Not applicable.

    Scientific details →

  • What happened to people with diabetes before insulin existed

    Mazur A. Nutr J 2011 · PMID 21396115 · DOI 10.1186/1475-2891-10-23
    Narrative reviewindependent cross-checkfull text checked★ key study

    Before 1922, children with diabetes usually died of diabetic coma within months to a few years, even on strict fasting diets; some starved to death.

    'The diabetes is not cured' (Allen); diet could not substitute for insulin.

    Does the study support the specific claim? No · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    To explain why fasting diets were used for diabetes before insulin and how patients fared.

    How was the study done?

    Historical analysis of published case series and textbooks.

    How many people, animals or samples were studied?

    Patients of Allen (76 published cases) and Joslin, 1914-1922.

    What was actually found?

    Most children died of coma within months to years; 43% of Allen's cases were dead by 1917; four died of starvation; diabetes was not cured.

    How large was the observed effect?

    43% mortality within a few years (Allen's series).

    What do the results mean in everyday life?

    Diet and fasting alone cannot keep insulin-deficient diabetes alive; insulin changed this.

    What are the study's limitations?

    Historical, uncontrolled data; diabetes types not distinguished.

    What does it say about Elawady's specific claim?

    Contradicts claims that diet can replace insulin or that ketoacidosis does not kill.

    Do the results apply to Germany and Europe?

    Universal biology.

    What can explicitly not be concluded from this study?

    Cannot give exact survival curves or separate type 1 from type 2 cases.

    Scientific details →

Studies with mixed or unclear results (4)

  • DiRECT after five years

    Lean ME et al.. Lancet Diabetes Endocrinol 2024 · PMID 38423026 · DOI 10.1016/S2213-8587(23)00385-6
    Randomised controlled trialindependent cross-checkfull text, structured risk-of-bias assessment

    Only 13% of those continuing support were still in remission at 5 years; people with long diabetes or on insulin were not studied.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Outcomes at 5 years with continued low-intensity support

    How was the study done?

    5-year extension study of a cluster-randomised trial (DiRECT)

    How many people, animals or samples were studied?

    85 extension; 149 controls; DiRECT participants

    What was actually found?

    Remission declines over time.

    How large was the observed effect?

    13% remission at 5 years

    What do the results mean in everyday life?

    Remission needs ongoing weight maintenance.

    What are the study's limitations?

    Extension group self-selected; many missing data (especially controls); open-label; only people with diabetes under 6 years and not on insulin.

    What does it say about Elawady's specific claim?

    Supports and limits C-DIAB-03 (durability).

    Do the results apply to Germany and Europe?

    UK.

    What can explicitly not be concluded from this study?

    Cure; remission in long-standing insulin-treated diabetes; effect of any diet other than this low-calorie programme.

    Scientific details →

  • How often lifestyle change puts type 2 diabetes into remission (Look AHEAD)

    Gregg EW et al.. JAMA 2012 · PMID 23288372 · DOI 10.1001/jama.2012.67929
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    About 1 in 9 people reached remission in the first year with an intensive lifestyle programme, but only 3.5% stayed in remission for 4 years.

    Remission possible (11.5% year 1) but rarely sustained (3.5% for 4 years).

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Measure remission in a lifestyle trial.

    How was the study done?

    Analysis of a large RCT.

    How many people, animals or samples were studied?

    4,503 adults.

    What was actually found?

    11.5% vs 2.0% (year 1); 3.5% sustained 4 years.

    How large was the observed effect?

    NNT about 10 (year 1).

    What do the results mean in everyday life?

    Lifestyle helps, but lasting remission is uncommon.

    What are the study's limitations?

    Exploratory analysis.

    What does it say about Elawady's specific claim?

    Contradicts 'cure' as a typical outcome.

    Do the results apply to Germany and Europe?

    Applicable.

    What can explicitly not be concluded from this study?

    Cannot apply to T1D.

    Scientific details →

  • What 'remission' of type 2 diabetes means

    Riddle MC et al.. Diabetes Care 2021 · PMID 34462270 · DOI 10.2337/dci21-0034
    Guideline / position statementindependent cross-checkabstract checked★ key study

    Remission means HbA1c below 6.5% at least 3 months after stopping diabetes drugs; it is not called a cure and needs ongoing checks.

    Remission (not cure) of T2D is recognised; requires follow-up.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Define T2D remission.

    How was the study done?

    Expert consensus.

    How many people, animals or samples were studied?

    Not applicable.

    What was actually found?

    HbA1c <6.5% >=3 months off drugs.

    How large was the observed effect?

    Not applicable.

    What do the results mean in everyday life?

    Remission is possible but needs follow-up.

    What are the study's limitations?

    Consensus.

    What does it say about Elawady's specific claim?

    Qualifies 'cure'.

    Do the results apply to Germany and Europe?

    Co-published in Europe.

    What can explicitly not be concluded from this study?

    Not applicable.

    Scientific details →

  • Who can stop insulin after a first episode of ketoacidosis?

    Raubenheimer PJ et al.. Diabetologia 2024 · PMID 38240751 · DOI 10.1007/s00125-023-06067-3
    Cohort studyindependent cross-checkabstract checked★ key study

    In Cape Town, about a quarter of adults could stay off insulin for 5 years, mostly those with a type 2-like profile; people with type 1 antibodies rarely could.

    Insulin independence depends on diabetes type and beta-cell reserve, not on a diet.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Find predictors of insulin independence after DKA.

    How was the study done?

    Prospective cohort with supervised weaning.

    How many people, animals or samples were studied?

    88 adults.

    What was actually found?

    46% at 1 year, 26% at 5 years off insulin; antibodies predict dependence.

    How large was the observed effect?

    OR 11.5 (acanthosis); 0.10 (antibodies).

    What do the results mean in everyday life?

    Stopping insulin is possible for some people with a specific type 2 profile, under medical supervision only.

    What are the study's limitations?

    Small study.

    What does it say about Elawady's specific claim?

    Partly qualifies 'nobody can stop insulin'; contradicts stopping it in type 1.

    Do the results apply to Germany and Europe?

    Phenotype rarer in Europe.

    What can explicitly not be concluded from this study?

    Cannot support stopping insulin without testing and supervision.

    Scientific details →

Regional context

Germany / EU

German guidance accepts remission through weight reduction as a goal in early type 2 diabetes.

Egypt

Lifestyle-based remission programs are less established; supervision is needed when reducing drugs.

What applies in my country?

General scientific assessment

Mostly false Early type 2 diabetes can go into remission with substantial, supervised weight loss, but this is not a cure and does not apply to type 1 or most long-standing insulin-treated diabetes; the claim that the Tayebat system cures diabetes is not supported.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.. Lean ME et al.. Lancet 2018 · PMID 29221645 · DOI 10.1016/S0140-6736(17)33102-1
  2. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial.. Lean MEJ et al.. Lancet Diabetes Endocrinol 2019 · PMID 30852132 · DOI 10.1016/S2213-8587(19)30068-3
  3. Effect of intensive lifestyle intervention on bodyweight and glycaemia in early type 2 diabetes (DIADEM-I): an open-label, parallel-group, randomised controlled trial.. Taheri S et al.. Lancet Diabetes Endocrinol 2020 · PMID 32445735 · DOI 10.1016/S2213-8587(20)30117-0
  4. Type 2 Diabetes Remission: A Systematic Review and Meta-analysis of Nonsurgical Randomized Controlled Trials.. Sherifali DT et al.. Diabetes Care 2025 · PMID 40982327 · DOI 10.2337/dc25-0562
  5. 8. Obesity and Weight Management for the Prevention and Treatment of Diabetes: Standards of Care in Diabetes-2026.. American Diabetes Association Professional Practice Committee for Diabetes. Diabetes Care 2026 · PMID 41358882 · DOI 10.2337/dc26-S008
  6. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.. Diabetes Control and Complications Trial Research Group; Nathan DM et al.. N Engl J Med 1993 · PMID 8366922 · DOI 10.1056/NEJM199309303291401
  7. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2026.. American Diabetes Association Professional Practice Committee for Diabetes*. Diabetes Care 2026 · PMID 41358900 · DOI 10.2337/dc26-S009
  8. Why were "starvation diets" promoted for diabetes in the pre-insulin period?. Mazur A. Nutr J 2011 · PMID 21396115 · DOI 10.1186/1475-2891-10-23
  9. 5-year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT) of continued support for weight loss maintenance in the UK: an extension study.. Lean ME et al.. Lancet Diabetes Endocrinol 2024 · PMID 38423026 · DOI 10.1016/S2213-8587(23)00385-6
  10. Association of an intensive lifestyle intervention with remission of type 2 diabetes.. Gregg EW et al.. JAMA 2012 · PMID 23288372 · DOI 10.1001/jama.2012.67929
  11. Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetes.. Riddle MC et al.. Diabetes Care 2021 · PMID 34462270 · DOI 10.2337/dci21-0034
  12. Phenotype and predictors of insulin independence in adults presenting with diabetic ketoacidosis: a prospective cohort study.. Raubenheimer PJ et al.. Diabetologia 2024 · PMID 38240751 · DOI 10.1007/s00125-023-06067-3

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