T2 Diabetes remission success rate for Low Calorie diets?

Oldvatr

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Does this constitute proof? https://pubmed.ncbi.nlm.nih.gov/21367948/
It says
Conclusions: Two weeks of dietary intervention (≈4.3% weight loss) reduced hepatic triglycerides by ≈42% in subjects with NAFLD; however, reductions were significantly greater with dietary carbohydrate restriction than with calorie restriction. This may have been due, in part, to enhanced hepatic and whole-body oxidation.​
Not sure. The actual paper is here
https://clinicaltrials.gov/ct2/show/NCT01262326

Edit to correct. This is not the same study, it is an earlier version. Please refer to the correct version which follows in a later post
 
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Oldvatr

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Not sure. The actual paper is here
https://clinicaltrials.gov/ct2/show/NCT01262326
It seems very invasive, with intravenous feed of among many things, glucose and ketones, I am not au fait with the methodology and will need to think about this a bit more. There may be reasons why a keto diet giving low glucose levels might skew the measurements rather than just as a lipid burner emptying the hepatic fat. It was not obvious on first read through. It seems they subject the drawn blood samples to an MRI scan, This is the bit that escapes me at the moment. I thought imaging was for body parts, not phials of blood.
OK done some more research and confirmed to myself that the only recognised means of measuring NFAFLD fat in a living person are: -
Biopsy sampling - invasive
Ultrasound scan - only 70% accurate at best, non invasive
CT scan - requires radioactive isotope and contrast added - body scan with x-rays, limited acess
MRI scan - now approved for clinical use and non invasive body scan - repeatable. non ionising does not require tracer or contrast.
The procedure described in the paper -
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076656/

Edit to correct, I was looking at the wrong version of their study, This version here is the new paper.
 
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Oldvatr

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Actually it seems I made a mistake and loaded up an early version of the study.

This is the real study paper, and it uses the MRI scanners properly to measure hepatic volume and uses spectroscopy to evaluate what was there. It is a better study than I thought above. and does seem to demonstrate that the keto diet burns liver fat at a faster rate than the low calorie diet. However, I note that the VLC diet is calorie restricted at 1200 kcal, not the 800 kcal of the Newcastle diet, so their comparative study is not quite like for like.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076656/

However, The team do not consider any long term effect, or attempt to establish if there is any form of remission for T2D. Note that the HbA1c from both arms end up with similar values and also with similar weight loss overall, So this study does not quite match the work done by Prof Taylor. It seems to be interested in NAFLD only. Also note that the HbA1c is used as a comparison, but the duration of the study intervention is only 2 weeks so not sure if that is valid.
 
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loiphamp

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I would be cautious and not take it too far. Diabetes seems to have a memory. I have added butternut squash and carrots from the start of my remission about 5 years ago. Over the last 6 months beetroot has also been added at the same time as celery - 2 HbA1c's in a row have been essentially the same. I will not ever add the grains, potatoes or processed foods.
we are different I'm not go full amount before I get diabetes.I know if I go full amount I'm go back diabetic.control eating will be a key to stay out of problems.
 

pdmjoker

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Actually it seems I made a mistake and loaded up an early version of the study.

This is the real study paper, and it uses the MRI scanners properly to measure hepatic volume and uses spectroscopy to evaluate what was there. It is a better study than I thought above. and does seem to demonstrate that the keto diet burns liver fat at a faster rate than the low calorie diet. However, I note that the VLC diet is calorie restricted at 1200 kcal, not the 800 kcal of the Newcastle diet, so their comparative study is not quite like for like.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076656/

However, The team do not consider any long term effect, or attempt to establish if there is any form of remission for T2D. Note that the HbA1c from both arms end up with similar values and also with similar weight loss overall, So this study does not quite match the work done by Prof Taylor. It seems to be interested in NAFLD only. Also note that the HbA1c is used as a comparison, but the duration of the study intervention is only 2 weeks so not sure if that is valid.
Looks like you've done some great research and looked into these things rather more than I have - thank you. (It's time consuming to assess studies and get to grips with all the relevant issues, so I appreciate it.)
Yes, shame that this study was only 2 weeks and 1200 kcal means not quite comparable, but does give some pointers.
I had heard both Jason Fung and Bret Scher say, and read in Volek and Phinney, that Low Carb enables liver fat to be burned off.
I gathered from Fung that the fructose in sugar is a prime cause of liver fat, but some people dispute this.
(In an earlier post of yours, might it be worth removing the link to the wrong version of the study?)
 

Oldvatr

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Looks like you've done some great research and looked into these things rather more than I have - thank you. (It's time consuming to assess studies and get to grips with all the relevant issues, so I appreciate it.)
Yes, shame that this study was only 2 weeks and 1200 kcal means not quite comparable, but does give some pointers.
I had heard both Jason Fung and Bret Scher say, and read in Volek and Phinney, that Low Carb enables liver fat to be burned off.
I gathered from Fung that the fructose in sugar is a prime cause of liver fat, but some people dispute this.
(In an earlier post of yours, might it be worth removing the link to the wrong version of the study?)
I did consider removing that other report, but I felt that since I managed to find it and act upon it, then it should stay and be commented on so my <<eyes being opened>> is a warning to anyone else wanting to use that version as any form of proof. The report I linked to was incomplete and was not actually what the team did in reality which turned out to be a much better bit of science. In essence that report was a prospect study, which makes it an intend to do rather than a look what we did. Its purpose is to raise funding for the work I should have checked for the wording but it is written in an informal style and not as most NIH reports are done. I have to admit that at the time I was responding in that post I was entering hypoland. I was there again last night so apologies if it all became a bit disjointed. My brain starts to get a bit fuzzy at 3.1 mmol/l, but shows I an fat adapted. My spellchecker did have to work harder than usual LOL
 

Mbaker

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we are different I'm not go full amount before I get diabetes.I know if I go full amount I'm go back diabetic.control eating will be a key to stay out of problems.
Not being argumentative but this phrase "we are different", I think is too much of a blanket that is used alot and too often in my view. I would say we are mainly the same with subtle differences. To explain, it is true we have different tastes, which is one side of the coin; this is not the same as saying that if I didn't "like" lamb, it would not work for me metabolically. As I see it, this difference is emotional, not physical in the same way as lactos or gluten intolerance.

I would say in the low carb keto area, an experienced advocate could create a spread of food that would satisfy the 80 / 20 rule for low carbers at a banquet. E.g. I would say ground beef, eggs, salmon or seabass as the protein, courgettes, cauliflower, green beans, cucumber, greens, brocolli, raspberries, strawberries, blueberries, blackberries as the carbs, Greek yogurt, cream, butter, coconut, olive oil, ghee as the fat, has an 80 / 20 cross over as a minimum to those on Keto - Carnivore, I would suggest would be even easier to meet the 80 / 20 rule.

I believe there are some digestive differences and taste differences, but I would posit that taste within the context of "being different" can be given disproportionate weight, which can make "being different" appear more like a physical limitation. The NFU states that 91% of Britain enjoy red meat https://www.nfuonline.com/nfu-onlin...riendly-farming-the-facts-about-british-meat/, this shows quite alot of being similar.
 

Prilotus

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I did the Newcastle diet in the last few months of 2017.Losing the first 15 lbs brought my BG down to normal, then I lost some more weight (about 7lbs) in the following 6 months, whilst only intending to stay level but being too cautious. Now I have put back that 7lbs during lockdown (I blame the ice cream!) and have just started this week, trying to lose it again, as the extra 7lbs has put my BGs back above the prediabetes threshold. It's not a disaster yet, but it can't go on. I have to lose that weight immediately or I could go back to full blown T2.
What is the Newcastle diet ? Not heard of it
 

Tannith

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What is the Newcastle diet ? Not heard of it
https://www.diabetes.org.uk/researc...ht/research-spotlight-low-calorie-liquid-diet This is about the Newcastle Diet and how it works. Basically you eat a low calorie diet for a few months. This removes the fat from your pancreas which is inhibiting it's adequate function. In order to lose the crucial few grams of fat which are clogging the pancreas you also have to lose a lot off the liver, as otherwise the liver would"feed" it back onto the pancreas as soon as the liver became loaded with fat again. After a few months and on average a 15kg weight loss you can eat a normal diet again - one containing adequate calories for your everyday needs but no more, otherwise you might start putting the pancreatic fat back on again. Everyone has a different "personal fat threshhold" or point at which their internal organs become so overloaded with fat that they become diabetic (T2). I only had to lose 15 lb,not 15 kg to get back to a healthy pancreas. You can do it with shakes if you want to, to make it easier to measure the calorie intake. But it absolutely doesn't HAVE to be shakes if you can work out a suitably low calorie diet for yourself with normal food (which is what I did).
 
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bulkbiker

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After a few months and on average a 15kg weight loss you can eat a normal diet again - one containing adequate calories for your everyday needs but no more, otherwise you might start putting the pancreatic fat back on again

I thought it was supposed to be 1/3 fewer calories than usual... that's what most of what I have read says about DiRECT.
You can never go back to your previous diet.. ever.
 

Tannith

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I thought it was supposed to be 1/3 fewer calories than usual... that's what most of what I have read says about DiRECT.
You can never go back to your previous diet.. ever.
You eat a NORMAL diet ie one with sufficient calories to support your everyday needs, but no more. If you were eating more than that before you started the Newcastle, then you were overeating previously, and that's probably how you accumulated the excess fat on the pancreas. Of course, now that you are 15kg on average (or in my case 15lb) lighter you will have a little less body weight to carry around, therefore your daily calorific need will be a bit lower. How much lower will depend on how overweight you were originally
 

WAGR57

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I had been low carbs for few years, now I can eat anything I want(ice cream,pasta,pizza...etc) for at least 6 months .HbA1C in normal range.
Interesting, I would like more info on this please. When you where diagnosed and what was your A1C at that time? What do consider normal A1C. Do you measure your morning BG? What is your age, I want to compare your situation with mine, if you don't mind.
 

loiphamp

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Interesting, I would like more info on this please. When you where diagnosed and what was your A1C at that time? What do consider normal A1C. Do you measure your morning BG? What is your age, I want to compare your situation with mine, if you don't mind.
I diagnosed on early 2016 .After back to normal diet in 2 months i got my first A1C(normal diet ) 5.6 .it's was 5.4 before that(6 months period )I'm 52 years old now.When I diagnosed A1C was 12.7 (USA)at Kaiser .I do not need test every morning.As you know when you are diabetic every high carbs meal will bother you but now I feel nothing bother me.
 

OrsonKartt

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...Hi all thanks for sharing your thoughts....this is all interesting stuff for me. Around 4 years ago I was diagnosed and against medical advise I did the Newcastle diet. 2 months of milk shakes etc. Within a few weeks my morning blood sugars were mid 5's low 6's . Personally I found the diet truly brutal, especially after the first month...... luckily I bumped into this site while still on the diet so after the 2 months went low carb. Most days now I eat around 10 -sometimes up to 20 grams of carb. - ive grown to like, even enjoy the life style . I test every day , it keeps me on track and motivated. I find that as time goes on I'm having to be more and more controlling in my life style to maintain the same blood glucose numbers. I dont know if this is par for the course. For me its a dynamic thing . I now usually fast till 12 mid-day and occasionally do a 24 hr fast if my numbers are going up. The implication from many on this site is that they get much lower numbers than me, but hey ho. My BMI when diagnosed was 25 its now 21 . I'm curious to read real life stories of what actually works , especially in the long term.
 

JohnEGreen

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After years of taking prednisolone my weight slowly but surely went up till one day I found my self at eighteen and a half stone with drug induced diabetes.

As exercise is not an option for me I decided to do both low carb and a restricted calorie diet below 50 gm of carbs a day and approximately 600 to 800 calories I did that for a year or so.

I lost about eight and a half stone going down to ten stones I have now relaxed that increasing calories but not carbs by very much.

So I am now about 11.5 stone still a pred induced diabetic but with carb restriction maintaining blood sugars in the normal range and unfortunately with half the muscle mass I used to have.

I don't know if it was the calorie reduction or the low carbs that made the largest difference but I suspect it was mainly the drastic and prolonged reduction in calories that lost me the fat and muscle but the reduction in carbs that was the main driver of the normal blood sugar levels I have obtained.

So I stick with LCHF and don't worry too much about calories.