Prof Taylor on the subject of Reversal.

[Krystyna23040]

Unfortunately the mantra that weight gain leads to type 2 diabetes is still being trotted out as unchallenged, and no proper trials are even being carried out to challenge that assumption.

I agree with you. My friend who I have known for 40+ years weighs 15 stone and has blood sugars that are on the low side of normal. I was 9at 6lbs when diagnosed with an hba1c of 125.

I have to keep to around 20g carbs to keep normalish blood sugars. So I definitely feel that weight gain is not the whole story. I just don't think my my body can cope with carbohydrates. Actually I am apparently 'in remission ' at a higher weight (9st 12lb) than when first diagnosed with T2D.

 

[Caprock94]

Another factor of course is that it's entirely possible (and maybe even enjoyable) to eat LC/Keto for the remainder of one's life. Extreme calorie deprivation not so much.

Agreed on that! I have found that low carb is a MUCH more sustainable way of eating for me than low calorie.

 

[Caprock94]

‘Type 2 Diabetes’ is often used as an umbrella term for anyone showing high blood glucose who isn’t easily and cheaply diagnosed with another type of diabetes. So there are many T1s and T3cs, LADAs, MODYs, drug induced, Bronze diabetics (and others) who are lumped in with those T2s whose insulin resistance and beta cell failure is affected by fat in the liver and pancreas.

While I applaud Professor Taylor’s work, I find it endlessly frustrating that many consider his work to apply to all ‘Type 2s’.

No.
It applies to those people with liver and pancreas fat, whose beta cells can return to function if that fat is removed.
There are many, many people classed as ‘type 2’ for whom weight loss is not going to improve their blood glucose control.
Indeed, the extreme diet often used to achieve such weight loss may be extremely unhelpful, especially to a patient who didn’t need to lose pancreas and liver fat in the first place.

Good points. Not everyone is alike. I know for me, I certainly needed to drop some weight (and change my diet). Weight is not an issue for all.

 

[Member496333]

To be honest, up to a point, gaining weight, or getting fat, is protective against diabetes. Think of it as excess glucose being safely stored away for another day. If you couldn’t get fat you would become diabetic almost immediately. The metabolic calamity begins when you start running out of capacity to store that energy. Pertinent to the topic, this is when the liver has little choice but to start packing itself and any nearby organs. This whole “fat makes you diabetic” thing is such crooked thinking.

 

[Walking Girl]

I would like to see more study on the scanning of the liver and pancreas in normal or low BMI T2 diabetics to confirm that they still have fat deposits which could impair metabolic function.

At the moment it seems to be assumed that fat is always the cause, and if you are skinny then there must be "concealed fat" somewhere causing your T2.

If this is proved, fine, develop a protocol for TOFI T2s. Including pancreas and liver scans.

If this is disproved it might stop T2s blaming themselves because however much weight they have lost it obviously isn't enough and they should just try harder.

Newcastle University is currently recruiting for just such a study. Diabetics with BMI of 27 or less (presumably upon diagnosis). The DiRECT study required a BMI of 27 or more, but not over 35. So overweight and obese, but not really morbidly obese. They are also scanning for organ fat in a non-diabetic control group. So, in 3-4 years we’ll have the answer. I wonder what people will say if he proves it works.

 

[Deleted member 308541]

I have posted this before here.

According to my GP and a CDE I spoke to at Diabetes Queensland, that there is no such thing a remission or reversed with T2 diabetes in Queensland.

This why I am saying I have my T2 under very good control, now if I start eating rubbish food again I will revert back to where I was nearly three years ago and not under control.

I am a T2 in recovery mode if you like, the same as a alcoholic that has not had a drink for a year or more.

 

[Mbaker]

I have posted this before here.

According to my GP and a CDE I spoke to at Diabetes Queensland, that there is no such thing a remission or reversed with T2 diabetes in Queensland.

This why I am saying I have my T2 under very good control, now if I start eating rubbish food again I will revert back to where I was nearly three years ago and not under control.

I am a T2 in recovery mode if you like, the same as a alcoholic that has not had a drink for a year or more.

I think the "remission" formal acknowledgement is a technically important aspect; and linking (without derailing this topic), could and I think should be vital in keeping meat a medicinal treatment (I think it is fair to say the majority on this site under 48 mmol are meat eaters, proving this nutrient is at least as good as others, I think.......). If a survey is performed of Type 2 diabetics who are below the threshold of full blown diabetes, it is easier for observers to understand the generic term of remission. We have a number of interests who want to restrict our choices.

Please consider all who can get a formal "Diabetes in Remission" if you can. For me it doesn't matter if you are an MD, PHD, Activist or whatever, this is hard to argue against:

 

[Deleted member 308541]

I think the "remission" formal acknowledgement is a technically important aspect; and linking (without derailing this topic), could and I think should be vital in keeping meat and a medicinal treatment (I think it is fair to say the majority on this site under 48 mmol are meat eaters, proving this nutrient is at least as good as others, I think.......).

Meat is part of the bodies repair / building kit so eating it is a must, I could not have got into recovery mode eating lettuce and **** alone.

 

[lucylocket61]

Meat is part of the bodies repair / building kit so eating it is a must, I could not have got into recovery mode eating lettuce and **** alone.

Why meat rather than any other protein?

 

[Deleted member 308541]

Why meat rather than any other protein?

Did you read the bit I quoted of @Mbaker who mentioned meat in his / her post.

It could well have been the fish, bacon, cheese, eggs, etc that I eat along side the various kinds of meat I go through.

 

[Krystyna23040]

Another factor of course is that it's entirely possible (and maybe even enjoyable) to eat LC/Keto for the remainder of one's life. Extreme calorie deprivation not so much.

I absolutely 100% agree with that. Have been doing LC/keto since mid 2016. Am never hungry and really enjoy my food now. Although I know that I will always have to stay LC/keto it is no hardship.

After years of low fat it still feels deliciously wicked to stir fry my my above ground veggies in butter, eat the skin from roasted chicken and have stilton cheese instead of cottage cheese. I could go on but it is making me hungry.

 

[Indy51]

Why meat rather than any other protein?

Quiet apart from reasons of taste, main reason I always choose animal products for protein is the science of the DIAAS score. Plant proteins don't even come close really, except maybe for soy (which comes with its own problems).

https://lentein.com/pdcaas-to-diaas-for-a-more-accurate-amino-acid-score/

Protein is even more important as we age if we're going to avoid osteoporosis, sarcopenia and maintain the lean muscle mass that will keep us on our feet instead of on the floor with broken bones.

 

[bulkbiker]

I wonder what people will say if he proves it works.

Well we know it only "works" for about a third of participants after 2 years.
That's what DiRECT has shown so far from a carefully selected group where remission can still leave them pre -diabetic.
I still feel that low carb (and even more extreme low carb) shows better success rates and is more sustainable for more people.

 

[AloeSvea]

Anyone who has read me over the years in here knows I always bring up the sick fat cell theory of diabetes (type 2). So here I am. This theory also covers Prof Taylor's, re fat deposits. It's not new! It's been around a while.

'Adiposopathy: sick fat causes high blood sugar, high blood pressure and dyslipidemia'
https://www.futuremedicine.com/doi/full/10.1517/14796678.1.1.39

"Accumulating scientific data suggest that in most patients, it is the dysfunction of adipose tissue (adiposopathy) that is the root mechanistic aetiology of abnormalities of glucose metabolism, blood pressure and lipid metabolism (Figure 1). These scientific data are substantiated by the common clinical observation that many patients who gain weight develop these metabolic abnormalities, and if these same patients subsequently lose weight, then these metabolic abnormalities improve or may potentially resolve."

and

"However, the relationship between excessive body fat and adverse metabolic consequences is not absolute. Obesity alone does not always result in clinical metabolic disease, and not all patients with these metabolic diseases are overweight. Recent and ongoing research into adipose function and dysfunction seem to be confirming these basic and common clinical observations. Studies are now supporting the concept that it is not the presence of excess adipose tissue alone, adiposity, that is causally related, but rather it is the dysfunction of adipose tissue, here termed ‘adiposopathy’, that should be identified as the root mechanistic aetiology of disorders of glucose metabolism, blood pressure and lipid metabolism."

I particularly like it as it explains my own diseased state, if I can say that. (Minus the blood pressure issues.)

 

[AloeSvea]

Oh! And what does sick fat cells have to do with reversal? My understanding is you have to replace the sick ones with healthy ones, and the lifespan of a fat cell is 10 years. (And that is about healthy eating.)

So how healthy you can get, ie with reversal, remission etc, has to do with how many sick fat cells you have, the time it takes to replace them, and if you can beat the 'complications' of type two in the meantime... (and that is about being physically active? I think so....)

 

[Caeseji]

Oh! And what does sick fat cells have to do with reversal? My understanding is you have to replace the sick ones with healthy ones, and the lifespan of a fat cell is 10 years. (And that is about healthy eating.)

So how healthy you can get, ie with reversal, remission etc, has to do with how many sick fat cells you have, the time it takes to replace them, and if you can beat the 'complications' of type two in the meantime... (and that is about being physically active? I think so....)

Honestly? A theory I do prescribe to for myself at least as I dropped a decent amount of weight early into my journey and achieved remission almost overnight. Considering how shockingly fast o developed type 2 and how many teens are getting that wonderfully attached condition (see: not actually wonderful but a PitA) it has a lot of merit. It really does make me think there are so many pathologies that lead to this dysfunctional state but also Taylor’s work and this that you have presented to us does give off hope that if we do treat ourselves right? There is always a way for our bodies to fight. Thank you for the reminder!

 

[Listlad]

It really does make me think there are so many pathologies that lead to this dysfunctional state.....

And would account for so much variety of circumstance amongst members.

 

[Member496333]

I actually believe that, in a sense, it's really rather simple in the majority of cases. Of course there are myriad confounding factors in many, but by-and-large I think it goes like this;

1. Overconsumption of excessive glucose leads to furious fat generation.
2. Fat cells run out of capacity to cope (in some this may be obese, in others it may not).
3. Diabetes.

 

[lucylocket61]

And then you have the people like me, morbidly obese, but with healthy blood pressure and cholesterol, and basically healthy.

 

[Little Bird]

I am of the other opinion. To me it was the depletion of the body fat that led to weight loss. On an ultra restricted diet, the body is tricked into thinking starvation is coming, so it starts raiding the body's long term stores, i,e, the lipids it secreted away for that rainy day. First it depletes the muscle stores, which is glycogen. Now glycogenis a mix of stored glucose and water, so depleting this store results directly in significant and fast weight loss as water is removed. This is how most weight loss diets work, indeed the Prof Taylor diet is the Cambridge Plan of the 80's using Optifast shakes and 800 kcal. the DIRECT plan used currently also uses the Cambridge Plan shakes again.

So initial weight loss is not what we term as body fat. Once the muscle stores are depeleted then the body raids the lipids stored in the liver (often blamed for the Dawn Phenomenon or Liver Dump) and when this runs out then the interesting stuff begins. There is a clarion call from the hormones for all good fats to come to defend the flag, so now we see adipose tissues such as the brown cells, and the pancreas and liver give up their remaining fat deposits, This is why prolonged use of this type of diet is not recommended since it leads to protein scavenging if fats are not included. That state is starvation.

Prof Taylor states in the extracted paragraphs in the OP that it is the removal of ALL body fat that does the magic. He also says the diet plan to get there is just a tool and does not have to be ultra low calorie, He used Optifast because it was a recognised diet acceptable to the NHS, and had controlled nutrition which he needed to eliminate confounders from the experiment. In other words, it was convenient.

Sorry Little Bird, it was the use of the word Reveral that we were critquing, not you. That is an emotive term. and since you were aiming this topic at newbies, it was important for us to make it clear that it is not the silver bullet or holy grail that they may be seeking. The work that Prof Taykor did and continues to do may in rime lead to that happy solution, but it is not yet in our hands, But it has given us another tool we can use.

Thanks @Oldvatr you're a gent. And yes I agree entirely that reversal is indeed an emotive subject and that there are no magic bullets or holy grail. I do think that if someone is Type2 and armed with a sound understanding of the pros and cons, and willing to keep an open mind then it is definitely worth a shot. However, if someone does try it and then fails to reverse their T2, and probably without ever knowing exactly why that it is, then that can lead to a very real disappointment and maybe self blaming, especially if they are considered overweight, and there may little or no help or support for this if the person is doing it on their own, unlike Prof Taylors subjects who had help and support.

Whilst reversal may be an emotive subject, I personally think the subject of weight loss is an even more emotive one. I have been obese for most of my adult life and have had more than my fair share of fat shaming and blaming, and it is deeply hurtful. I think fat shaming and blaming is abusive and bullying and medical professionals especially should know better!

I have lost a lot of weight since my diagnosis, over 5 stone, and even if it had not reversed my T2 I would not regret losing that weight for a moment. Before I used to get out of puff just walking up a flight of stairs, now I can practically sprint up one. It was major battle with my belly just to cut my toe nails or tie my shoe laces up! I don’t miss all that stuff for a moment. I have more energy now, I sleep better and am able to be so much more active and involved in life. I feel twenty years younger!

BUT it was not easy by any stretch. It wasn’t about anything so simple as just finding ways to not feel hungry, for me the difficulty was more about life changes. Losing weight for me involved some major lifestyle changes. I had to learn to give up an entire lifetimes worth of eating habits, rituals and crutches etc. It was psychologically and emotionally hard!

It is so easy just to say lose weight and you could reverse your type 2 diabetes, but actually doing it is not nearly so easy. If you do try it and it doesn’t work out then there is all too often a sense of failure and shame, and that can be harmful and destructive to a ones self-esteem and self-worth.

So yes! I couldn’t agree more, it is very important to make it clear that it is not the silver bullet or holy grail that someone may be seeking. You do right Oldvatr!