Another Interesting Article

Dr Snoddy

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KennyA

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https://www.nature.com/articles/s41467-021-25667-4?utm_source=bing_null&utm_medium=cpc&utm_campaign=NCOM_1_SZ01_P5_clinical-ACD-bing&utm_term=for diabetes control&utm_content=A randomized controlled trial of pharmacist-led therapeutic carbohydrate and energy restriction in type 2 diabetes
Although this article looks primarily at the role of pharmacists in management of Type 2 it does clearly demonstrate the potential value of a low carbohydrate diet as a method of treatment. What I did find interesting were the positive outcomes for people who had been diabetic for a number of years.
Thanks for posting. It's encouraging to see that anecdote (ie the experience of many of us here) is being confirmed by research.
 
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EllieM

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Doctors need to get on board this with T2, we've heard so many instances of basic lack of knowledge and intransigence.

To be fair, T2 is just one of many illnesses that family doctors are required to treat. The impression I get is that they just follow the guidance from their country's medical bodies (eg NHS). GPs aren't experts. While the eatwell plate is still pushed by the NHS, youcan't blame the surgeries for following it.
 

Dark Horse

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Note that the diet was low carbohydrate AND low calorie. The primary aim was to see if the management of concomitant medication reduction could be done by community pharmacists rather than the Canadian equivalent of GPs .
 

Outlier

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Very interesting reports - thank you both for posting them.

When I went on keto at the end of September, I wasn't expecting weight loss, but I certainly got it! So it would be useful to have a study on keto and low carb that isn't low-calorie. I have fought my weight bitterly all my life, had to give up when the menopause hit and absolutely destroyed me and I couldn't take the pain of being constantly hungry as well as all the other stuff. Then I went into keto as soon as I had the Type 2 diagnosis, and-off came the weight and I haven't been hungry since I started it. Oh, and my blood glucose has stabilised at non-diabetic levels, though this is with 2 x 500 metformin per day, which I intend to reduce/cut out after I have seen Nursie again at the end of this month.

I could have saved myself years and years of misery if I'd only known about keto. It suits me, so I'm lucky there. I do wish the medics would learn about it, but it's just too easy and uncomplicated to be convincing. And it doesn't make money for anyone.
 

Ronancastled

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Gummesson et al.22 reported a linear ‘dose-dependent’ relationship between weight loss and HbA1c reduction, with an estimated mean HbA1c reduction of 0.1 percentage points for each 1 kg of weight loss. In the current trial, the mean weight loss was approximately 12 kg, which suggests a mean reduction in HbA1c of around 1.2 percentage points - close to our observed point estimate of 1.4 percentage points

That's the first time I've ever seen that quantified.

I also see the diet was true low carb, almost Keto

We conducted a 12-week pragmatic, community-based parallel-group randomized controlled trial (ClinicalTrials.gov: NCT03181165) evaluating the effect of a low-carbohydrate (<50 g), energy-restricted diet (~850-1100 kcal/day
 
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Bubbleblower

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I'd like to see a 12 year follow up instead of a 12 week one to see if they managed to keep the weight of.
From what I understand they usually don't and regain the fat, but not the muscles.
It must be hard to also exercise on only 850 calories or so.
 

Deediabetic

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To be fair, T2 is just one of many illnesses that family doctors are required to treat. The impression I get is that they just follow the guidance from their country's medical bodies (eg NHS). GPs aren't experts. While the eatwell plate is still pushed by the NHS, youcan't blame the surgeries for following it.

I was at a party with an endocrinologist who is in their late 30s and are not too many years out from getting their qualifications. They specialised to be an endo and admitted to me that they learnt barely anything as part of their qualifications about what type 2 diabetics should be eating. They said that it was only working with the national body here on a short contract and being in contact with the dietitian who worked in the office, that they learnt about ins and outs of what a type 2 should be eating. Unfortunately they were told about eating low GI carbs and the eatwell plate! They also hadn't heard about the Newcastle diet either. If an endo knows nothing much about type 2 diabetes management by way of appropriate diet then I hold out little hope for a GP knowing much either about diabetes.
 

thepolly

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I'd like to see a 12 year follow up instead of a 12 week one to see if they managed to keep the weight of.
From what I understand they usually don't and regain the fat, but not the muscles.
It must be hard to also exercise on only 850 calories or so.

I had lots more energy when following the 800 cal blood sugar diet. Am doing badly now and am taking meds (which feels like I failed myself). I hate tablets but being on them gives me a good incentive to go back low carving and get off the meds. Also reintroduce the exercise stuff.
 

thepolly

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Meds since yesterday so really new to them. Metformin, Dan something and the one that stops you having a heart attack or stroke from high blood pressure. I'm not happy with myself at all.
 

RosemaryJackson

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Tbh, even the Diabetic nurses go by the rules of the NHS. When I go for my next blood text, my nurse will be gobsmacked how much my levels and A1c will have come down, I will tell her that I eat low carb (even without their permission) and she should really look into it. Surely results for patients should raise interest?
 

Daphne917

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Meds since yesterday so really new to them. Metformin, Dan something and the one that stops you having a heart attack or stroke from high blood pressure. I'm not happy with myself at all.
Do you mean statins which they prescribe, whether you need them or not, for cholesterol?
 

bulkbiker

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I'd like to see a 12 year follow up instead of a 12 week one to see if they managed to keep the weight of.
From what I understand they usually don't and regain the fat, but not the muscles.
It must be hard to also exercise on only 850 calories or so.
Then again 6 years down the line I have kept off most of my lost weight so I'm halfway to your 12 year target.
 

Oldvatr

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https://www.nature.com/articles/s41467-021-25667-4?utm_source=bing_null&utm_medium=cpc&utm_campaign=NCOM_1_SZ01_P5_clinical-ACD-bing&utm_term=for diabetes control&utm_content=A randomized controlled trial of pharmacist-led therapeutic carbohydrate and energy restriction in type 2 diabetes
Although this article looks primarily at the role of pharmacists in management of Type 2 it does clearly demonstrate the potential value of a low carbohydrate diet as a method of treatment. What I did find interesting were the positive outcomes for people who had been diabetic for a number of years.
The RCT trial had a binary outcome. The TCR group were given a diet plan that was both LC and VLC combined. The study lasted 12 weeks so is basically the ND plan but acknowledging it to be LC. They do not define what the diet plan actually consisted of in the abstract. Maybe the full report has this. We cannot assume LCHF or keto, since that is not what ND likes to be classed as, Indeed the phrase low carb low calorie implies a low fat diet.

This study is to demonstrate that pharmacists can lead an intervention based on the Newcastle or 800 style diet.

Edit: the study used Ideal Protein commercial weight loss shakes, with some whole foods added. so it is ND with a Canadian accent.
 

Pipp

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The RCT trial had a binary outcome. The TCR group were given a diet plan that was both LC and VLC combined. The study lasted 12 weeks so is basically the ND plan but acknowledging it to be LC. They do not define what the diet plan actually consisted of in the abstract. Maybe the full report has this. We cannot assume LCHF or keto, since that is not what ND likes to be classed as, Indeed the phrase low carb low calorie implies a low fat diet.

This study is to demonstrate that pharmacists can lead an intervention based on the Newcastle or 800 style diet.

Edit: the study used Ideal Protein commercial weight loss shakes, with some whole foods added. so it is ND with a Canadian accent.
The regime I used following advice from the Newcastle team, eleven years ago, was indeed low carb as well as low calorie. Ketosis was the key, and that occurred within days of starting. Also I was able to exercise , swimming and intense aquafit sessions for at least 2 hours daily.
 

Erin

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https://www.nature.com/articles/s41467-021-25667-4?utm_source=bing_null&utm_medium=cpc&utm_campaign=NCOM_1_SZ01_P5_clinical-ACD-bing&utm_term=for diabetes control&utm_content=A randomized controlled trial of pharmacist-led therapeutic carbohydrate and energy restriction in type 2 diabetes
Although this article looks primarily at the role of pharmacists in management of Type 2 it does clearly demonstrate the potential value of a low carbohydrate diet as a method of treatment. What I did find interesting were the positive outcomes for people who had been diabetic for a number of years.

"Reversed" is a strong word, and losing weight is a welcome goal, but unfortunately it has become difficult for me due not only to lockdown but a knee injury preventing movement. I just eat less, which is always more calorie reductive than exercise. This is an optimistic article. Thank you.
 
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Oldvatr

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The regime I used following advice from the Newcastle team, eleven years ago, was indeed low carb as well as low calorie. Ketosis was the key, and that occurred within days of starting. Also I was able to exercise , swimming and intense aquafit sessions for at least 2 hours daily.
I agree. When ND first hit the streets it was hailed as a VLC diet - pure and simple. The team denied that it was low carb (and most defintely not Low crab), but a quick calculation of the Optifast shakes nutrient list showed that it was indisputably LC as well, but just above ketosis levels for most. It was definitely low fat as well. Advocates for the ND also insist it is the caloric restriction that is important, but followers of this forum know that that is often in dispute in threads. It is in fact a mix of both, as the Canadian study clearly discusses. It is still low fat, though. And ketosis is not far away with the ND
 
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Pipp

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I agree. When ND first hit the streets it was hailed as a VLC diet - pure and simple. The team denied that it was low carb (and most defintely not Low crab), but a quick calculation of the Optifast shakes nutrient list showed that it was indisputably LC as well, but just above ketosis levels for most. It was definitely low fat as well. Advocates for the ND also insist it is the caloric restriction that is important, but followers of this forum know that that is often in dispute in threads. It is in fact a mix of both, as the Canadian study clearly discusses. It is still low fat, though. And ketosis is not far away with the ND
The ‘success’ in the resarch paper in the OP can be claimed by both low carb and low calorie /low fat camps it would appear.
 

Oldvatr

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The ‘success’ in the resarch paper in the OP can be claimed by both low carb and low calorie /low fat camps it would appear.
At first glance that would seem so, but actually it is only the combined diet that was the success story, so Low Carb cannot actually claim this as a victory. VLC can claim both this and ND