Dec 2014 update: New research on the Low Carb Diet in general practice

[Brunneria]

List!!?????

My OH is lucky if I remeber to label stuff in the freezer. We've had some very "special", "surprise" meals.

Ahem.

Labels?

What a strange concept! Excavating in my freezer is rather like a Narnian lucky dip.

Especially when I've stored the dogs raw BARF diet in the same storage pots as my pulled pork.

 

[modesty007]

Labels?

What a strange concept! Excavating in my freezer is rather like a Narnian lucky dip.

Especially when I've stored the dogs raw BARF diet in the same storage pots as my pulled pork.

My guess they would both do your good, not sure about the pulled pork for the dogs.

 

[modesty007]

As a big cheese lover, sometimes I also have a listing of my cheeses in the fridge.

 

[modesty007]

with expire dates.....

 

[NoCrbs4Me]

Labels?

What a strange concept! Excavating in my freezer is rather like a Narnian lucky dip.

Especially when I've stored the dogs raw BARF diet in the same storage pots as my pulled pork.

Personally, I keep barf and pulled pork in separate containers, not the same.

 

[douglas99]

Personally, I keep barf and pulled pork in separate containers, not the same.

I've never wanted to see my barf again.
But that was mainly in my student days, years ago.

 

[anniflower]

Suffering from list mania, I list all my stuff in the freezer

I do too, but then forget to add or delete and it all goes downhill. We sometimes have U F Os in our freeze - Unidentified Frpzen Objects. I do label, (mostly! but they sometimes come off

 

[Southport GP]

Looking through the forum I was sorry to hear how some of you met a rather closed response from your health professionals .About two years ago I began working with a group of 19 pre-diabetic and type two diabetic patients (insulin dependent patients were not included) who were interested in maximizing the benefits of a good diet and wanted to try a lower carb, higher fat diet. I thought if I could get the work published by a reputable peer reviewed journal you would then have something to share with your doctors, nurses and dieticians. I am particularly interested in the goal of maximizing the effect of diet BEFORE starting medication and find many patients agree.

THE RESULTS : Weight and HbA1c down significantly ,also improvements in blood pressure, liver function tests and interestingly cholesterol despite a diet higher in fats (coconut oil ,butter, olive oil and lots of eggs) Over the last year I have come to feel that the starch in bread, pasta (even whole meal) rice and potatoes is actually concentrated sugar, with a higher glycemic index than table sugar itself. So no surprise that diabetics may struggle to deal with these items in their diet. It seems to me that HOWEVER any particular overweight patient looses weight their Type 2 diabetes improves. This can lead to some rather stark choices between weight loss and medication!

Update march 24/03/2014; find the full article free to view here;
http://www.practicaldiabetes.com/Sp.../March 2014/PP Unwin final proofs revised.pdf
The idea is that you can also show it to health care professionals involved to show them its a valid choice of diet

Update two; 26/12/2014; how are we doing after a year on the diet?

The success of this small pilot enabled us to get a grant from the Southport CCG to run nurse-led evening clinics and extend the low carb approach.
Now after an average of a year on the low-carb diet the number of type 2 diabetics in the cohort has increased from 19 to 31, the average weight loss is still 9.113 Kg (95% confidence interval of this difference: From 6.569 to 11.656) with a mean drop in HbA1c of 8.482mmol/mol (95% confidence interval of this difference: From 2.079 to 14.88) None of the patients who gave up metformin have needed to re start it either.
Coming up next -The liver and low carbing, very nearly ready for publication
Please find more detail in my Dec 2015 Diabesity in Practice article free to view here;
http://www.diabesityinpractice.co.uk/media/content/_master/3963/files/pdf/dip3-4-131-4.pdf

One way or another we have all eaten our way into this diabesity epidemic, this has been my way to help patients eat their way out of it again!

Going 'online' is as a GP has some dangers which is why I must point out it's not really ethical for a doctor to give specific advice so I cannot answer questions relating to an individual case -sorry. My hope was that the work could help inform the debate between people with diabetes and the health professionals who care for them.

And finally.., I just want to say how much I have learnt from the clever folk on this great blog. Thanks!!

When I re wrote this I should have added the results for average serum cholesterol after a year on the diet were about the same as after 6 months

 

[Lamont D]

I have watched your thread with interest.
I have been low carbing for over a year now.
I have struggled for over a decade to lose weight and my blood results, BP and other tests have been very poor year on year and I couldn't lose weight no matter how I tried.
My life change was my consultant and this forum.
All my tests are very good and I have my condition under control.

 

[Southport GP]

A researcher in the low carb field was explaining to me that there is some evidence that diabetic controll can improve on the diet without weight loss
This hasn't been my experience particularly- Have any of you found this to be true ?

 

[douglas99]

A researcher in the low carb field was explaining to me that there is some evidence that diabetic controll can improve on the diet without weight loss
This hasn't been my experience particularly- Have any of you found this to be true ?

I lost weight, and improved my control dramatically.
But if you low carb, it would surely stand to reason that carbohydrate intolerance would no longer apply, as you no longer eat the carbs to be intolerant to?

I suppose the test is to let your patients low carb for a while, then subject them to a GTT?
The next part of your study perhaps?

 

[robert72]

A researcher in the low carb field was explaining to me that there is some evidence that diabetic controll can improve on the diet without weight loss
This hasn't been my experience particularly- Have any of you found this to be true ?

Yes - as a very low-carbing Type 1, I have maintained my weight over the last 15 months at around 66-67 Kilos although my control has improved greatly almost from day one.

 

[tim2000s]

A researcher in the low carb field was explaining to me that there is some evidence that diabetic controll can improve on the diet without weight loss
This hasn't been my experience particularly- Have any of you found this to be true ?

I think it depends on the total amount consumed. As a T1, I lose weight when low carb and 2000 cals per day or lower. At around 2200-2500 I remain stable.

It has made an improvement to my control.

 

[Brunneria]

A researcher in the low carb field was explaining to me that there is some evidence that diabetic controll can improve on the diet without weight loss
This hasn't been my experience particularly- Have any of you found this to be true ?

I've been low carb high fatting (ketogenic) for about a year. Lost about 20 pounds, very slowly (which is what I wanted), still very morbidly obese. No meds. BG consistently between 5.3-7.0 mmol/l unless I eat too many carbs. Previously low carbing, but not in ketosis, I was usually 6-8.5 mmol/l.

I have very high insulin resistance (PCOS and micro prolactinoma) so my expectations have never been to slim down, reverse the Big D and skip into the sunset, but I am unexpectedly delighted with the way this is working. Way beyond my expectations.

Looking forward to the next year, further very slow, gentle weight loss, and continuing to feel better than for over 20 years.

 

[AndBreathe]

A researcher in the low carb field was explaining to me that there is some evidence that diabetic controll can improve on the diet without weight loss
This hasn't been my experience particularly- Have any of you found this to be true ?

To be honest, I think most of us who have tried it have lost weight, even if that's not been our aim. It was certainly the case for me, although I was happy to trim up, but my absolutely primary objective was glycemic control.

For me, the challenge was stabilising the weight when I reached, and crashed through my target weight. At 49kg and a BMI of 19, I certainly don't want to be going lower.

 

[Brunneria]

As @AndBreathe says, my primary goal was BG control, never weight loss.
That was a pleasant surprise.

 

[Lamont D]

I too was only interested in gaining control. I had to! It was my overriding decision!
The weight loss was a bonus! A really nice significant bonus!

I really never thought that I could ever lose weight!

 

[NoCrbs4Me]

@Southport GP - have you seen this article:

http://meridianvalleylab.com/wp-content/uploads/2012/08/GITT-Article-Re-type1.pdf

and this book:

http://bookstore.trafford.com/Products/SKU-000161736/Diabetes-Epidemic--You.aspx

?

Reading the article made me think we are missing a lot focusing mostly on blood glucose and not looking at insulin levels and response.

I also found it interesting that the author stated that "No causal relationship between obesity and diabetes mellitus was shown in this study."

Your thoughts?

 

[Southport GP]

You make a good point -for type two diabetes, insulin resistance is probably key. Here is an interesting study in exchange
Mary C Gannon123*† and Frank Q Nuttall13†’Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition Nutrition & Metabolism 2006, 3:16 doi:10.1186/1743-7075-3-16
However in my practice the average person with diabetes on our trial had a BMI of 34 and lost 9KG while their diabetes was sorted.

 

[douglas99]

You make a good point -for type two diabetes, insulin resistance is probably key. Here is an interesting study in exchange
Mary C Gannon123*† and Frank Q Nuttall13†’Control of blood glucose in type 2 diabetes without weight loss by modification of diet composition Nutrition & Metabolism 2006, 3:16 doi:10.1186/1743-7075-3-16
However in my practice the average person with diabetes on our trial had a BMI of 34 and lost 9KG while their diabetes was sorted.

Have they successfully done a GTT, when you say 'sorted'?