Here's my opinion on things I can take away from doing the ND over the last eight weeks.
1
It works, it does what it says on the can, if you stick to it, don't cheat, and stay sensible. It's based on the principle of shocking the liver into burning its stored fat so that it recovers insulin sensitivity. That requires a radical drop in energy intake. I think that if you don't do this, the liver recovery will be limited and probably short-term. In my first week, I saw a big drop in FBG down to normal levels, literally within a few days. I think everyone will see that but those who drop out early, will see very little long-term benefit even if they lost some weight.
2
The big drop in FBG signals the shift to burning fat by the liver and an almost immediate recovery of some insulin sensitivity. That means you have to be aware of the effect of your medications. If you are on insulin-stimulating drugs or insulin itself, you need to be aware of the appropriate new doses. Your GP, if they're supportive, should be able to advise you. I didn't have that supportive GP so I had to play it by ear, monitor closely, and make adjustments. It's safe providing you make small changes and monitor closely. If in any doubt, talk to your GP.
3
I rightly reduced my medication as my FBG came down but I made a mistake in assuming that I'd be able to eliminate my insulin altogether. It was over-optimistic, over-ambitious and I couldn't do that. I'm a long-standing diabetic and had I read the research more carefully, I would have realised that the recovery of the pancreas is by no means assured. If you've had diabetes for more than ten years, it can take a long time, and may never happen. I was too optimistic, too early, and continued the reduction of my dose throughout weeks 2 and 3 so that by the end of week 4, I had stopped my insulin, down from 56U to zero in a fortnight. My FBG started to climb quite dramatically after a few days of zero insulin and I had to reinstate the insulin, back up to 35U, which I have maintained to the end of week 8. This stabilised my FBG in the range of 4s and 5s. The take-away lesson here is that medication is an issue and medical advice is important, especially for anyone taking insulin. Despite clinical trials which say all medication was eliminated, that's under clinically controlled and monitored conditions - if you're doing the ND on your own, you need close monitoring and may need to maintain some medication under GP advice. It's a medical issue and forum advice cannot be a substitute for a medically-informed GP judgement.
4
Weight loss is a complex business. The energy in = energy out (gluttony & sloth) story is a complete myth because it doesn't account for metabolic rate, efficiency, and a number of other significant factors. The presence of insulin encourages the deposition of triglycerides so whilst it keeps FBG numbers good, it inhibits weight loss. Low energy intake therefore does not guarantee weight loss - it can simply result in a lower metabolic rate. This is what I saw in my own case - 98kg for weeks on end with only 800 kcals per day is certainly counter-intuitive! By the end of week 8, I was tired much of the time. Balancing the insulin, energy intake, and activity level can result in some weight loss - I managed it in the end - but it's tricky and it's easy to jump to the wrong conclusions. If you're in this position, I think you need to control all three factors very carefully and consistently and not jump to conclusions. Small changes, made slowly, is the best way. The best you are likely to get is a small, slow, gradual decrease in weight. Reducing insulin to increase weight loss will likely push up FBG and that in turn, feeds the vicious cycles affecting the liver and pancreas so it's not a solution that can be maintained. Any continued reduction in FBG will require some restored functionality from the pancreas and that is likely to take a long time for long-standing diabetics. I think a further reduction in insulin depends on recovered function in the pancreas which may be a long time coming so perhaps I'm stuck with the insulin for some time to come. I didn't fully appreciate all this until I started to control the insulin and activity level much more carefully.
5
Diets, and especially the ND, are not ends in themselves for me, so success on a diet isn't just determined by how easy or difficult it is, whether or not I enjoy it, or by how much weight is lost. To me, the ND is a medical intervention and the aim is to restore functionality to the liver and pancreas so that the diabetic condition can be contained and maybe reversed. So the ND, and any of the well-known diets, is just the first step and it will need to start a longer-term process of protecting the liver and pancreas with appropriate weight, appropriate food. In a sense 'life style' is the wrong phrase, it doesn't need the 'style' bit. It's not a hobby or a pastime, something to pick up and drop in order to choose an alternative. For me this is about correcting and restoring a damaged metabolism, and whatever it takes isn't about lifestyle, it's about health. And there are lots of regimes to help with that and doubtless I'll look at a number of them with much greater understanding now.
6
The use of a forum such as this is really, really valuable. Not just because of the useful, pertinent, detailed advice regularly on offer, but as an essential sounding board, a corrective, to what we might be thinking. It's very useful to have a comment like "Have you thought about..." or "Some people have reported that..." or "Have you seen the research from...". Going through an attempt to recover control over diabetes can be an emotional as well as physical experience and our judgements can easily be swayed back and forth, optimistic and pessimistic in turn. Everyone's experience can help providing we are open-minded, respectful, and think about what we're given. We shouldn't feel sleighted if our idea isn't accepted (it's about the ideas rather than whoever is presenting them) - rather we should ask ourselves why and see if it's a reasonable rejection. I've changed my mind over a number of things as a result of comments and advice on this forum and I thank everyone for that. It's really helped.
7
Perhaps the most important thing I take away from all this is the clear need for detailed, accurate, consistent, scientific explanation. Us diabetics are inundated with all manner of suggestions about how to manage the condition. Some suggestions are clearly without merit but very many others are simply unclear, or undecided. We can try them all out but without controlled conditions, we can never fully trust our own individual conclusions. We might believe something works but we can't know it. In the case of the ND, there is solid reliable science behind it. In addition there is a growing body of empirical clinical evidence from clinicians like Fung who have detailed their results for critical examination. That's something we can trust, study, and understand. There are still lots of holes but I'm confident that the core of the scientific problem has been solved and that this approach can and does work. Of course it has to be optimism tempered by realism. But solid science gives good grounds for hope.
All the best, everyone.