Low-Carb And No-Meds For More Than 20 Years?

[Grateful]

One of the frequent criticisms made by the medical community of the low-carb, low-med (or zero-med) treatment for Type 2 diabetes is that there aren't enough controlled medical studies (as far as I can't tell, there aren't any such studies) proving that it works in the long term.

Personally, as someone who adheres to the scientific method, this bothers me quite a lot. Indeed, it bothers me even though places like this forum provide overwhelming anecdotal evidence that the low-carb treatment works. Plus, it bothers me even though I have now become an anecdote myself: the low-carb method worked, in my case.

From Wikipedia: Anecdotal evidence is evidence from anecdotes, i.e., evidence collected in a casual or informal manner and relying heavily or entirely on personal testimony. When compared to other types of evidence, anecdotal evidence is generally regarded as limited in value due to a number of potential weaknesses, but may be considered within the scope of scientific method as some anecdotal evidence can be both empirical and verifiable, e.g. in the use of case studies in medicine. Other anecdotal evidence, however, does not qualify as scientific evidence, because its nature prevents it from being investigated by the scientific method. Full definition here: https://en.wikipedia.org/wiki/Anecdotal_evidence.

The "gold standard" in medical science is the long-term, double-blind controlled study. We don't seem to have any of those, as far as low-carb/no-meds treatment for T2 is concerned. (I hope I am wrong about this. If there are such studies, where can we find them?)

So here is my question: Is there any forum member reading this who has been on the low-carb programme for at least 20 years, and is still showing healthy BG levels without taking meds? Plus a corollary question: If so, have you seen any signs that the low-carb diet, while successfully controlling diabetes, had any drawbacks whatsoever for your health?

 

[Bluetit1802]

So here is my question: Is there any forum member reading this who has been on the low-carb programme for at least 20 years, and is still showing healthy BG levels without taking meds? Plus a corollary question: If so, have you seen any signs that the low-carb diet, while successfully controlling diabetes, had any drawbacks whatsoever for your health?

You could start a poll thread, asking how long members have followed low carb without meds and still showing good BG results. Give them a choice of several years, such as up to 1, 1 to 2, 3 to 4, or whatever, and so on up to above 10. It is unlikely there will be members on here with 20 years of T2 and well controlled without meds. People like that are unlikely to be on this forum. I could, of course, be wrong, but I can't think of any.

You would of course have to define low carb, how low carb, and how high fat and protein. These are all important for future health markers.

 

[Grateful]

You could start a poll thread, asking how long members have followed low carb without meds and still showing good BG results. Give them a choice of several years, such as up to 1, 1 to 2, 3 to 4, or whatever, and so on up to above 10. It is unlikely there will be members on here with 20 years of T2 and well controlled without meds. People like that are unlikely to be on this forum. I could, of course, be wrong, but I can't think of any.

You would of course have to define low carb, how low carb, and how high fat and protein. These are all important for future health markers.

I will try to do that. If so, it will be in the Type 2 Diabetes forum, since it doesn't really count as a Success Story.

Such a poll still falls squarely into the definition of "anecdotal evidence" of course. Self-reporting, self-selecting and without controls. But it could be very interesting!

Edited to add: I forgot to say thank you very much for the suggestion!

 

[Grateful]

All right, I had a go at creating a poll. Unfortunately it looks like the software only allows a single question per poll (you can create lots of choices for the answers but only a single question). Perhaps I have misunderstood the software?

I am a member of other fora where you can post multiple-question polls.

 

[Bluetit1802]

All right, I had a go at creating a poll. Unfortunately it looks like the software only allows a single question per poll (you can create lots of choices for the answers but only a single question). Perhaps I have misunderstood the software?

I am a member of other fora where you can post multiple-question polls.

I've never created a poll so don't know how it works. Perhaps just make sure you define exactly what you mean by a low carb diet in the question? Maybe say under 50g with higher fat and normal protein, or however you personally define it?

 

[Grateful]

I've never created a poll so don't know how it works. Perhaps just make sure you define exactly what you mean by a low carb diet in the question? Maybe say under 50g with higher fat and normal protein, or however you personally define it?

About the only thing I could do would be, as you suggest, to provide a definition of "low-carb" (your definition looks good) and then the (single) question would be, "For how many years have you kept your BG levels under good control using only a low-carb diet?" However I am not sure how useful that would be. Among other things, it would be good to hear from people for whom it did not work. I suppose that could be the first answer in the list: "It did not work for me" or it could be just "zero years."

If you read up about "anecdotal evidence" a key issue is that you tend to hear only one side of the story. So in this case, you would hear from a lot of people who successfully used low-carb. Those for whom it did not work would not be counted, or would be under-counted. Plus, because of the lack of a proper testing framework, there would be no way to tell whether people who say they tried the low-carb method all did it in the same way or counted the carbs properly. In addition, even if we provided a checkbox for those who failed to control their BGs with low-carb, we could not guarantee that it would be a useful count, because it is possible that low-carbers are over-represented as forum members.

All sorts of problems!

Which leads us back to anecdotal evidence. I really am curious to know whether anyone has done this for 20+ years....

 

[Guzzler]

I viewed a youtube vid where Charlotte Summers said that DCUK had started just such a study. It is in its infancy though. Perhaps some of the staff members could help you find more info on this.

 

[kokhongw]

So here is my question: Is there any forum member reading this who has been on the low-carb programme for at least 20 years, and is still showing healthy BG levels without taking meds? Plus a corollary question: If so, have you seen any signs that the low-carb diet, while successfully controlling diabetes, had any drawbacks whatsoever for your health?

Why don't you post a poll on low fat diet as well...there seems to be world wide support for that, I am sure there should be overwhelming evidence...

 

[ringi]

The "gold standard" in medical science is the long-term, double-blind controlled study. We don't seem to have any of those, as far as low-carb/no-meds treatment for T2 is concerned.

Please tell me how you can take a group of poeple and have half of them eating low carb without them knowing about it? (Otherwise you can't make the study double blind.)

 

[ringi]

The best anecdotal evidence is that the few GPs in the UK how use "low carb" have lower drug costs and much better result for all of their cleints with Type2.

With also know from large studes looking at records, that people who keep their BG low for the longist before they go out of contorl have the lease problem. Hence even if "low carb" only puts off problems for 10 years, it is worth it.

Its not as if we have somethink else that works to compare it with................

 

[Resurgam]

I was never tested for diabetes even though when I was instructed to follow a high carb diet I felt dreadful - high carb and low calorie caused me to collapse, and during my first pregnancy I got away with eating low carb foods all through, so the urine tests would not have shown any sugar - after diagnosis I did the urine testing for the diabetes education sessions and just once got the smallest colour change. Not the smallest as denoted on the tin, just a slight alteration in the colour.
I have been eating low carb since the 1970s, when I had symptoms of reactive hypoglycemia mid afternoon - told I was having panic attacks.
I suspect that I have been diabetic for a long time - but the low carb eating, which also controlled my weight, disguised all symptoms. Now I am back eating the same diet I am - once again - absolutely fine, and I will not take orders from any HCP about what is right for me. The Metformin and statins were awful, life was not worth living.
If you go to the Atkins Diet page on Wiki it is described as a fad diet - insert information about diabetes being suppressed by it and put in a link to this forum and it is removed in minutes.

 

[sally and james]

While it doesn't quite answer the OP's question, @Grateful may be interested in the random control trials lists about LC compiled by the Public Health Collaboration, https://phcuk.org/wp-content/upload...ring-Low-Carb-To-Low-Fat-Diets-13.03.2017.pdf
Sally

 

[Grateful]

Please tell me how you can take a group of poeple and have half of them eating low carb without them knowing about it? (Otherwise you can't make the study double blind.)

Good question! I have no idea and no professional expertise. Perhaps you could somehow disguise food so that people would not know what they were eating, but how??? In particular, it is hard to see how it could be anything but a short-term study: weeks, not months or years.

Plus, if it were a long-term study, I would have problems with the ethics. If it turned out that one group was doing much better than the other after a few months, would it be OK to continue the experiment for several years?

While it doesn't quite answer the OP's question, @Grateful may be interested in the random control trials lists about LC compiled by the Public Health Collaboration, https://phcuk.org/wp-content/upload...ring-Low-Carb-To-Low-Fat-Diets-13.03.2017.pdf
Sally

Thanks, that is quite interesting. In particular, you can see that nearly all of the studies are short ones (weeks or months, seldom years).

One thing that is really interesting is how diabetics were treated before the discovery of insulin in the 1920s. Wait for it ... they were put on low-carb diets! Many of them, especially the Type 1s, must have ended up with drastically shortened lives in the absence of supplemental insulin but I assume some Type 2s did OK, or at least as OK as was possible in the context of limited diet knowledge back then. Perhaps you would have to go back at least a century to find people who had been on a low-carb T2 treatment for decades!

The "Diet Doctor" site has a link to the contents of a book for diabetics from that era, with a detailed list of foods that are OK to eat and those that are forbidden. The book, which was published exactly 100 years ago, is called "Diabetic Cookery -- Recipes and Menus" and the entire contents are readable here: https://archive.org/details/diabeticcookeryr00oppeiala.

See especially the tables on Page 13 ("Foods Strictly Forbidden") and Page 12 (foods that are good for diabetics because of their "great nutritive qualities"). Also Page 14: "Foods Arranged According To Percentage Of Carbohydrates."

Edited to add that on page "v" (five, roman numeral) in the Preface, the author states: Inasmuch as each person's carbohydrate tolerance is different, it is absolutely essential that the carbohydrate content of each recipe be known; only then can it be safely used. Furthermore, under some conditions, when the carbohydrate content of the diet is reduced, extra protein and fat are prescribed by the doctor to meet the energy requirement of the individual.

That is about as succinct a description of today's "LCHF" diet as you could find!!

I am not suggesting that us modern-day diabetics use that book today, but it is amazing how much they already knew about low-carb treatment for diabetes, a century ago. Then insulin treatment came along -- and thank goodness it did! But ironically some of the old diet wisdom then took a back seat.

 

[Grateful]

I viewed a youtube vid where Charlotte Summers said that DCUK had started just such a study. It is in its infancy though. Perhaps some of the staff members could help you find more info on this.

I would love to see that.

 

[Guzzler]

I would love to see that.

It may have been a video with David Unwin but I couldn't swear to it, I've seen so many.

 

[Alexandra100]

Good question! I have no idea and no professional expertise. Perhaps you could somehow disguise food so that people would not know what they were eating, but how??? In particular, it is hard to see how it could be anything but a short-term study: weeks, not months or years.

Plus, if it were a long-term study, I would have problems with the ethics. If it turned out that one group was doing much better than the other after a few months, would it be OK to continue the experiment for several years?



Thanks, that is quite interesting. In particular, you can see that nearly all of the studies are short ones (weeks or months, seldom years).

One thing that is really interesting is how diabetics were treated before the discovery of insulin in the 1920s. Wait for it ... they were put on low-carb diets! Many of them, especially the Type 1s, must have ended up with drastically shortened lives in the absence of supplemental insulin but I assume some Type 2s did OK, or at least as OK as was possible in the context of limited diet knowledge back then. Perhaps you would have to go back at least a century to find people who had been on a low-carb T2 treatment for decades!

The "Diet Doctor" site has a link to the contents of a book for diabetics from that era, with a detailed list of foods that are OK to eat and those that are forbidden. The book, which was published exactly 100 years ago, is called "Diabetic Cookery -- Recipes and Menus" and the entire contents are readable here: https://archive.org/details/diabeticcookeryr00oppeiala.

See especially the tables on Page 13 ("Foods Strictly Forbidden") and Page 12 (foods that are good for diabetics because of their "great nutritive qualities"). Also Page 14: "Foods Arranged According To Percentage Of Carbohydrates."

Edited to add that on page "v" (five, roman numeral) in the Preface, the author states: Inasmuch as each person's carbohydrate tolerance is different, it is absolutely essential that the carbohydrate content of each recipe be known; only then can it be safely used. Furthermore, under some conditions, when the carbohydrate content of the diet is reduced, extra protein and fat are prescribed by the doctor to meet the energy requirement of the individual.

That is about as succinct a description of today's "LCHF" diet as you could find!!

I am not suggesting that us modern-day diabetics use that book today, but it is amazing how much they already knew about low-carb treatment for diabetes, a century ago. Then insulin treatment came along -- and thank goodness it did! But ironically some of the old diet wisdom then took a back seat.

Thank-you SO much for the Diabetic cookery book. There are recipes there I might well try, notably some using almond flour. I'm not keen on the frequent use of saccharin, but on the other hand anyone wanting to increase their consumption of fat will find lots of ideas. The lists are handy too. A treasure trove, with some excellent hints generally useful for cookery - eg how best to whip cream (keep it very cold).

 

[Grateful]

Thank-you SO much for the Diabetic cookery book. There are recipes there I might well try, notably some using almond flour.

It is a fascinating book. I had only glanced at it a few weeks ago, but today I had a closer look.

Personally I would not be trying any of the recipes because https://www.dietdoctor.com/ has a great assortment of low-carb recipes (and so have other websites) including lots of recipes that use almond flour (which I buy in 4-pound bags!). I trust these modern sources better, when it comes to accurate measurement of the carbs, and the ingredient lists are those available today!

Edited to add: Remember also that the notion of foods that are "forbidden" reflects the situation 100 years ago. They were forbidden because you might die if you ate them! No injectable insulin back then! Today we can be slightly more relaxed, I think.

 

[ringi]

Lets remember that there have been no controled studies to show that low fat was a good option......

And that the grouth of Type2 has tracked the reduction in fat being eaten and the increased in processed food.

 

[Jay-Marc]

John Rollo is the person usually credited as the physician first recommending a low carb high fat diet for diabetes in a paper published in 1797 although he called it a 'meat diet'. At the time diabetes was considered a kidney disease from the arising sweet urine being the main testable symptom. Mind you there were various other diets proposed through the 19th century based around potatoes, oatmeal and skimmed milk and periods of fasting.

 

[Grateful]

John Rollo is the person usually credited as the physician first recommending a low carb high fat diet for diabetes in a paper published in 1797

Interesting. I just did some reading about Rollo, and about diabetes research in the 19th century. After figuring out a crude version of the low-carb diet, doctors of that era found that it had a positive effect for some adult diabetics, extending their life by a number of years, but that it did not help diabetic children (for whom the disease, at the time, was a death sentence). I assume that's because the adults who were helped happened to be T2s, whereas almost all child diabetics (and the adults for whom diet-alone did not prolong life) would be T1.

The discovery of the role of the pancreas came as late as 1889 I think. IIRC, researchers found that a dog would develop diabetes if you removed its pancreas.

My apologies, this is really off-topic for this thread (and I'm the one who started the thread!). Very interesting stuff though, and it makes one really grateful to have been born after, say, the 1920s when insulin was identified and soon started being used therapeutically.