Type 2 Diabetes: NHS to offer 800 cal diet

[bulkbiker]

According to NICE Guidelines NG28 as last updated in 2017
"
Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
• there is evidence of hypoglycaemic episodes or
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
• the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy.

That's what I mentioned to Dr Kar but he pointed out it is "guidelines' not policy.. I did ask him to tell me how that wouldn't be used as policy by CCG's but he declined to answer that one...

 

[dawnmc]

I've tried Michael Mosleys 8 week blood sugar diet, along with kettlebells, I did it for 7 weeks, logged every morsel of food on fitness pal, and lost...wait for it...nothing!!!

 

[pixie1]

The NHS plan is targeted at T2D specifically. It seems to reduce the Insulin Resistance that is a characteristic of that condition, and is something that a T1D is unlikely to suffer from. The diet is therfore probably not so suitable for T1D except as a pure weight loss program. T1D would need to continue insulin treatment during and after the diet period, so will not experience reversal. Some Insulin Dependant T2D et al may see improvement depending on the reason for their insulin need.

T1 diabetics can go on to become insulin resistant, then have to take meds. What happens is, some people eat whatever and cover it by injecting, then lose insulin sensitivity

 

[pixie1]

According to NICE Guidelines NG28 as last updated in 2017
"
Do not routinely offer self-monitoring of blood glucose levels for adults with type 2 diabetes unless:

• the person is on insulin or
• there is evidence of hypoglycaemic episodes or
• the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
• the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy.

It's amazing that those who have done their research, know nice guidelines is nonsense. R's not about being hypo, its all about being hyper, therefore it th rose the eat well and balanced diet in affray.
People believe that the advice is correct. If you read the NICE guidelines for professionals they think that Joe blog vs, do not understand diabetes, incapable of self managing and monitering, not understand the results of the Bm. First treatment in some practices is go straight to metformin and not diet, exercise to control diabetes, they think people are NOT capable

 

[Oldvatr]

According to a mild twitter spat with Partha Kar yesterday that's not true! Although he didn't come up with any evidence and I have struggled to find any concrete data.
My own views on ND are fairly well known but if anything can be considered a "fad diet" then surely replacing food with artificially concocted shakes must be a prime contender. Yes the results have been promising but I still haven't seen any 5 year follow up data even though the initial trials started in 2011? It does make me wonder why?

DIRECT was a 2 year study with 3 year follow up. The anniversary is 5 Dec 2018 for the end of the 2 years, The last update from Newcastle ac was in Dec 2017, and there have been no press releases since.then. So we should expect something soon,

 

[Oldvatr]

It's amazing that those who have done their research, know nice guidelines is nonsense. R's not about being hypo, its all about being hyper, therefore it th rose the eat well and balanced diet in affray.
People believe that the advice is correct. If you read the NICE guidelines for professionals they think that Joe blog vs, do not understand diabetes, incapable of self managing and monitering, not understand the results of the Bm. First treatment in some practices is go straight to metformin and not diet, exercise to control diabetes, they think people are NOT capable

There was an extensive review of SMBG in NG28 (2015) but the findings have been redacted down to what I posted above. The full report is quite sizeable,

I think that NICE found that for the majority of T2D they are generally elderly and not so tech savvy/ There is also concerns that patients will suffer heightened anxiety if they self monitor, Those here on the forum are generally literate and capable of benefitting from SMBG, but this does not cover the majority of T2D that a GP sees on a day to day basis. We live in a bubble here on this forum and are not representative of the general populace.

 

[lucylocket61]

unfortunately, I react to starvation/Very low calorie diets by almost coming to a full stop energy wise and mentally, and then put on more weight, on fewer calories, when I start to eat again.

cart before the horse treatment again.

 

[pixie1]

There was an extensive review of SMBG in NG28 (2015) but the findings have been redacted down to what I posted above. The full report is quite sizeable,

I think that NICE found that for the majority of T2D they are generally elderly and not so tech savvy/ There is also concerns that patients will suffer heightened anxiety if they self monitor, Those here on the forum are generally literate and capable of benefitting from SMBG, but this does not cover the majority of T2D that a GP sees on a day to day basis. We live in a bubble here on this forum and are not representative of the general populace.

Heightened anxiety and the use of the A1c was put forward for the need not to test. Under NICE guidelines. Self management and holistic approach i.e. What the patient would like suppose to be supported towards their own care. This is not happening,

I put forward the argument that testing is crucial for self management and awareness which foods effect glucose levels. My diabetic nurses also said low carbing is unsustainable, which is not the case if well supported. Obviously more sustainable than the ND, which i think is great to kick start the process and metabolis, then switch to low carb.

 

[DCUKMod]

According to a mild twitter spat with Partha Kar yesterday that's not true! Although he didn't come up with any evidence and I have struggled to find any concrete data.
My own views on ND are fairly well known but if anything can be considered a "fad diet" then surely replacing food with artificially concocted shakes must be a prime contender. Yes the results have been promising but I still haven't seen any 5 year follow up data even though the initial trials started in 2011? It does make me wonder why?

I'm away from home for a few days, communing with academics, so haven't seen a great deal of Twitter. Did you have a spat with Dr Kar?

 

[bulkbiker]

DIRECT was a 2 year study with 3 year follow up. The anniversary is 5 Dec 2018 for the end of the 2 years, The last update from Newcastle ac was in Dec 2017, and there have been no press releases since.then. So we should expect something soon,

No I meant Counter balance or whatever it was called the first 2 proof of concept ND trials..

 

[bulkbiker]

I'm away from home for a few days, communing with academics, so haven't seen a great deal of Twitter. Did you have a spat with Dr Kar?

Just a diddy one.. I think he has muted me..you were right!

 

[Debandez]

@Debandez bbc article is asking for contact from t2’s.

Do you have type 2 diabetes? Would you take part in this low-calorie diet if your GP offered it to you? Have you been on a similar diet in the past? Email [email protected] .
Please include a contact number if you are willing to speak to a BBC journalist. You can also contact us in the following ways:
WhatsApp: +44 7555 173285
Tweet: @BBC_HaveYourSay
Text an SMS or MMS to 61124 or +44 7624 800 100
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Could be your chance to get the low carb alternative and your article and message in there!

Im on it! Thanks for the tag, I've had guests staying with me all week and missed so much!!!

 

[walnut_face]

That's what I mentioned to Dr Kar but he pointed out it is "guidelines' not policy.. I did ask him to tell me how that wouldn't be used as policy by CCG's but he declined to answer that one...

Hmmm HMRC only issue 'guidelines' See what happens if you dont adhere to them

 

[Tannith]

I agree, When you explain it like this then it becomes clearer, and I was just concerned that Newbies may get the wrong ideas which is why I added the explanation since although I am a Low Carber myself, I do see the ND as viable especially for those not wanting the extra fuss of LC.

The point you make about the problems of follow through not being supported is valid, and of concern, since we do see reversals and needing to repeat the diet. It IS a diet in that it is time limited and not sustainable in long term, but I see it as a start to getting the NHS to consider using diet more robustly than it does at present. It is the first time I have seen the NHS admit to having a possible contender to bariatric surgery, which is their only cure mechanism to date. We should encourage this trial, since it may open the door to lifestyle changes such as LC being accepted at last. It is a stepping stone.

I had no problem keeping the weight off after the ND (which I did with real food). After all that effort who is going to want to throw it all away and put the weight back on! In fact, 11 months after finishing I have actually lost 10lb more without actually trying (to lose any more that is, obviously I tried to keep off the weight I lost). And without any support. I just counted calories and reduced portion sizes, so that I did not overeat as I had been doing before. I can now tolerate a sensible amount of carbs like a non diabetic without raising my BGs

 

[Diawara]

I've tried Michael Mosleys 8 week blood sugar diet, along with kettlebells, I did it for 7 weeks, logged every morsel of food on fitness pal, and lost...wait for it...nothing!!!

really ? i followed it for about six weeks probally nearer 1000 calories per day then followed lchf way of life since...the weight fell off in feb 2015 when diagnosed i was 119 kilos [ i had lost a bit since january ] after the eight weeks i had got down to 103 kilos now i am 99 kilos steady since may. bloods feb 12.5 june 5.5 september 5.3 ...............

 

[Diawara]

I had no problem keeping the weight off after the ND (which I did with real food). After all that effort who is going to want to throw it all away and put the weight back on! In fact, 11 months after finishing I have actually lost 10lb more without actually trying (to lose any more that is, obviously I tried to keep off the weight I lost). And without any support. I just counted calories and reduced portion sizes, so that I did not overeat as I had been doing before. I can now tolerate a sensible amount of carbs like a non diabetic without raising my BGs

i agree withyou /... see previous posting and i add that ive got more go about me mind sharper and fifteen years of knee pain and sciatica gone...

 

[dawnmc]

really ? i followed it for about six weeks probally nearer 1000 calories per day then followed lchf way of life since...the weight fell off in feb 2015 when diagnosed i was 119 kilos [ i had lost a bit since january ] after the eight weeks i had got down to 103 kilos now i am 99 kilos steady since may. bloods feb 12.5 june 5.5 september 5.3 ...............

Yep really, I'm one of those despite being low carb just cannot lose the menopause weight I put on.

 

[lucylocket61]

I had no problem keeping the weight off after the ND (which I did with real food). After all that effort who is going to want to throw it all away and put the weight back on! In fact, 11 months after finishing I have actually lost 10lb more without actually trying (to lose any more that is, obviously I tried to keep off the weight I lost). And without any support. I just counted calories and reduced portion sizes, so that I did not overeat as I had been doing before. I can now tolerate a sensible amount of carbs like a non diabetic without raising my BGs

that only works if you actually were overeating before.

 

[Oldvatr]

No I meant Counter balance or whatever it was called the first 2 proof of concept ND trials..

We discussed these some while back, and you had the info then, Have you mislaid it? I found you to be the fount of knowledge there. The papers were published and archived and we had links in the Forum. This is where I found out all I know about ND,

 

[bulkbiker]

We discussed these some while back, and you had the info then, Have you mislaid it? I found you to be the fount of knowledge there. The papers were published and archived and we had links in the Forum. This is where I found out all I know about ND,

Counterpoint it was called published in 2013..I still have the e-mail from Prof Taylor but have never seen any follow up..
77 participants all from home not much extra support.. Significant success but wouldn't a 5 year follow up have been great?