Carbs-independent remission

[chrisjohnh]

I have wondered whether any of our members with T2D has achieved remission through deliberate weight loss and then maintained it for at least a year whilst regaining no weight and, subject to that strict proviso, consuming as many carbs as they fancied. The investigators in the DiRECT trial take the view that this is what remission really means, i.e. being able to eat freely provided no weight gain. Literally all their participants who remained in remission after 2 years did not adopt a low carb to do it, so I am told.

 

[chrisjohnh]

I have wondered whether any of our members with T2D has achieved remission through deliberate weight loss and then maintained it for at least a year whilst regaining no weight and, subject to that strict proviso, consuming as many carbs as they fancied. The investigators in the DiRECT trial take the view that this is what remission really means, i.e. being able to eat freely provided no weight gain. Literally all their particiiants who remained in remission after 2 years did not adopt a low carb to do it, so I am told.

As a postscript, I am in remission on a low carb diet but thinking of doing my own experiment to test this out.

 

[HSSS]

Nope. I lost the weight ~ 18kg 20% and low normal bmi reached (albeit by low carb but Taylor himself says method doesn’t matter), achieved remission (drug free normal levels). I stayed there for more nearly 4yrs. BUT If I increase carbs I increase weight and bgl.

I can’t find that definition of remission in the documents (Eat freely without weight gain) just being sub 48mmol.

 

[bulkbiker]

The investigators in the DiRECT trial take the view that this is what remission really means, i.e. being able to eat freely provided no weight gain.

That's virtually impossible to maintain if you have lost weight through crash dieting.. which is after all what Taylor's diet really is.
Taylor himself says that intake will need to be reduced by about 30% forever in order to maintain the loss (because of course he follows the flawed CICO model) .

So it certainly isn't eating freely.

Also remission in their eyes is being pre-diabetic. Sub 48 mmol/mol
Not a result I'd aim for particularly.

 

[hankjam]

I have wondered whether any of our members with T2D has achieved remission through deliberate weight loss and then maintained it for at least a year whilst regaining no weight and, subject to that strict proviso, consuming as many carbs as they fancied. The investigators in the DiRECT trial take the view that this is what remission really means, i.e. being able to eat freely provided no weight gain. Literally all their participants who remained in remission after 2 years did not adopt a low carb to do it, so I am told.

Low carb and weight loss for 8 years. In remission.

Definitions are the thing.
That sounds like a cure, not going there.
Remission, to me means, it's gone away and might come back.

 

[Ronancastled]

Problem is if we start eating carbs again we just kick off the cycle once more.
We are susceptible to weight gain if our insulin levels become elevated.
Low insulin diet for life.

That saying, I can eat about 200gs of carbs some days & maintain perfect BG, wouldn't do it every day though.
Sometimes I throw in a sneaky Keto day just to feel good.

 

[chrisjohnh]

What I was told during discussion with the principal investigator is that after the crash-diet phase the remitters resumed eating that was reduced somewhat (so not literally free) but with unrestricted and freely chosen macronutrient composition, and that the remitters maintained their position for the rest of the two-year period - and that not a single one of them went on low carbs. Well, I don’t know what to make of it all, but I’m minded to up my carbs from 125 to 180 for 3 months and see what happens. I suspect my A1c will rise but who knows? Just curious to see if remission life is possible without constant fear of catching sight of a bread crumb or half a banana!

 

[AndBreathe]

What I was told during discussion with the principal investigator is that after the crash-diet phase the remitters resumed eating that was reduced somewhat (so not literally free) but with unrestricted and freely chosen macronutrient composition, and that the remitters maintained their position for the rest of the two-year period - and that not a single one of them went on low carbs. Well, I don’t know what to make of it all, but I’m minded to up my carbs from 125 to 180 for 3 months and see what happens. I suspect my A1c will rise but who knows? Just curious to see if remission life is possible without constant fear of catching sight of a bread crumb or half a banana!

I think some "not going low carb" and eating fewer carbs are the same thing.

My take on some of these things is if I starved myself for several weeks, and felt the better for the results of that - whether in terms of wellbeing or being slimmer or able to do more, I'd do my utmost not to go backwards. I think it also noteworthy that these people are participating in research. Knowing your "performance" will be measured periodically might influence behaviours in some.

I mean, we only have to look at the reactions on forum when some folks find they have an A1c unexpectedly, or around Christmas.

In addressing your question, there is a lovely chap called @andcol who had incredible results some years ago. I did a search on his name, and Newcastle Diet and the following came up:

Search Results for Query: newcastle diet

www.diabetes.co.uk

 

[Resurgam]

Knowing how hard it is to maintain weight loss whilst eating carbs I am impressed that they found anyone who managed it.

 

[chrisjohnh]

I think some "not going low carb" and eating fewer carbs are the same thing.

My take on some of these things is if I starved myself for several weeks, and felt the better for the results of that - whether in terms of wellbeing or being slimmer or able to do more, I'd do my utmost not to go backwards. I think it also noteworthy that these people are participating in research. Knowing your "performance" will be measured periodically might influence behaviours in some.

I mean, we only have to look at the reactions on forum when some folks find they have an A1c unexpectedly, or around Christmas.

In addressing your question, there is a lovely chap called @andcol who had incredible results some years ago. I did a search on his name, and Newcastle Diet and the following came up:

Search Results for Query: newcastle diet

www.diabetes.co.uk

Fascinating read on that link, thank you!

 

[chrisjohnh]

Knowing how hard it is to maintain weight loss whilst eating carbs I am impressed that they found anyone who managed it.

I can tell you that their unswerving belief is that if T2Ds clear out all their ectopic fat soon after diagnosis then most of them will get their A1c below 48 (I know, not the biggest deal) and can keep it there indefinitely by carefully not regaining weight whilst otherwise eating what they like. They would argue that with a well-resurrected pancreas one should not produce excess insulin in response to a high dollop of carbs and therefore should not suffer an adverse effect such as weight regain. I think their view is that if you’ve still not cleared your ectopic fat then keeping your A1c low merely by low carbing is just a “poor man’s kind of remission”, just a trivial demo of the obvious that you won’t get high flames from the fire in your innards simply by desisting from throwing fuel on it, even though it’s still smouldering underneath and will eventually create a crisis. Now I don’t know what the reality is here because the research is still too sparse and low scale. But I may do my own n=1 non-RCT experiment before long.

 

[HSSS]

What I was told during discussion with the principal investigator is that after the crash-diet phase the remitters resumed eating that was reduced somewhat (so not literally free) but with unrestricted and freely chosen macronutrient composition, and that the remitters maintained their position for the rest of the two-year period - and that not a single one of them went on low carbs. Well, I don’t know what to make of it all, but I’m minded to up my carbs from 125 to 180 for 3 months and see what happens. I suspect my A1c will rise but who knows? Just curious to see if remission life is possible without constant fear of catching sight of a bread crumb or half a banana!

Well as I said above I fitted all their criteria for remission in terms of weight loss and as soon as I increased carbs more than the very rare occasion it all started to go backwards again. Good luck if you achieve it but seeing as the original Newcastle trials were only about 50% successful I’m not sure I believe the reported conversation claiming 100% success.

 

[chrisjohnh]

Well as I said above I fitted all their criteria for remission in terms of weight loss and as soon as I increased carbs more than the very rare occasion it all started to go backwards again. Good luck if you achieve it but seeing as the original Newcastle trials were only about 50% successful I’m not sure I believe the reported conversation claiming 100% success.

I think I will find the same too, as even after freeing the pancreas from fat it may no longer respond as quickly and precisely in all of us as it once did, hence the bind we are in. They do not claim 100% success in remission - it was only about 45% at one year and about 35% at two. What they are claiming is 100% of those still in remission at two years had not needed a low carb diet during the second year; they had eaten what they liked BUT kept their weight stable.

 

[Antje77]

What they are claiming is 100% of those still in remission at two years had not needed a low carb diet during the second year; they had eaten what they liked BUT kept their weight stable.

By eating less to keep their weight stable, they likely ate less carbs too.
And now being aware of calories, chances are they had especially less of the obvious sweet, carby and fatty stuff like cakes, crisps, coke and the likes, unintentionally lowering carbs further.

 

[chrisjohnh]

By eating less to keep their weight stable, they likely ate less carbs too.
And now being aware of calories, chances are they had especially less of the obvious sweet, carby and fatty stuff like cakes, crisps, coke and the likes, unintentionally lowering carbs further.

Could be - I’d want to drill into their diet details. But suppose they had stabilised on, say, daily 2000 cals and maintained weight on that. I doubt they’d been limiting carbs to below 130g or even below 200g. They’d not shrunk from “normal” moderate intakes of bread, pasta, fruit etc., so I was told. They were living modestly trimmed normal lives again, carbs a complete non-issue for them. Mmmm … I wonder.

 

[AndBreathe]

Could be - I’d want to drill into their diet details. But suppose they had stabilised on, say, daily 2000 cals and maintained weight on that. I doubt they’d been limiting carbs to below 130g or even below 200g. They’d not shrunk from “normal” moderate intakes of bread, pasta, fruit etc., so I was told. They were living modestly trimmed normal lives again, carbs a complete non-issue for them. Mmmm … I wonder.

Are you suggesting that you can't low carb at 2000 calories? (Apologies if I'm being dim.)

 

[chrisjohnh]

Are you suggesting that you can't low carb at 2000 calories? (Apologies if I'm being dim.)

No, certainly not suggesting that! Rather, I’m conjecturing that these participants were probably on about 2000 cals in the second year and were on nothing like as little as 130g of carbs, probably more like 200.

 

[HSSS]

I think I will find the same too, as even after freeing the pancreas from fat it may no longer respond as quickly and precisely in all of us as it once did, hence the bind we are in. They do not claim 100% success in remission - it was only about 45% at one year and about 35% at two. What they are claiming is 100% of those still in remission at two years had not needed a low carb diet during the second year; they had eaten what they liked BUT kept their weight stable.

But I was still in remission at 2 and 3 yrs and definitely could not eat what I liked macro wise so I would blow the 100% stats they claim

 

[chrisjohnh]

But I was still in remission at 2 and 3 yrs and definitely could not eat what I liked macro wise so I would blow the 100% stats they claim

And had you, like me, brought your weight down to the extent of looking like me, a shrivelled stick insect without the slightest trace of tummy fat?

 

[Resurgam]

The thing is though, I got down to a Hba1c of 41 at 6 months from diagnosis eating a low carb diet. That is my new normal.

If I wanted to eat carbs freely by maintaining my weight I wouldn't be able to eat anything freely - I would constantly be weighing myself, going for long walks or taking other exercise for hours every day, eating a bit of salad rather than a meal - fretting my life away in order to try to maintain my weight against what is the natural course of my metabolism.

These days I spend exactly zero minutes concerned about my diet, I don't weigh myself, I do have to spend time in making clothes in smaller sizes, usually when the season changes. I don't do exercise as such, I just live my life without concerns about diabetes or diet.