ADA starts discussion on Keto

[kokhongw]

Hence my intital skepticism. Cannot help feeling that they’re paying keto lip service because they know it’s gaining traction. Lure in the interested, pretend to be impartial and then scare them off. Arguably paranoid but probably not far off the truth.

I agree they have been pretending to support lower carbs for a decade at least...but yet never provide any real practical support or resources to dietitians or doctors. This is clear from the lack of proper low carb discussion, programs or resources of any kind on their web channels etc.

But it is ok, all these google searches on low carb and keto will never be directed to their channels...there's no lack of authoritative, helpful keto/low carb resource online. ADA is just not one of them...

 

[Tophat1900]

Let's not get carried away. Remission does not mean the same thing as cure and for those of us with severe beta cell dysfunction (or a high level of beta cell death) the very best we can hope for is a long time in remission before more treatment is needed. I just thought a reality check was called for at this point.

Yes, agreed.

That is pretty much my story so far. Pancreas did well for a long time, but eventually it couldn't keep up. Needed insulin about a year ago, but the amount required is minuscule on a low carb/keto diet. Even starting off on a basal and humalog, the amount of humalog I was using per day was 10 - 13 units per day. However, nowadays I'm using 1 unit per meal and that is plenty. Basal dose hasn't changed.

Are you also using insulin? Don't mean to be nosy, but I can't remember you using it before. Or maybe I've got it all wrong.

 

[Guzzler]

Yes, agreed.

That is pretty much my story so far. Pancreas did well for a long time, but eventually it couldn't keep up. Needed insulin about a year ago, but the amount required is minuscule on a low carb/keto diet. Even starting off on a basal and humalog, the amount of humalog I was using per day was 10 - 13 units per day. However, nowadays I'm using 1 unit per meal and that is plenty. Basal dose hasn't changed.

Are you also using insulin? Don't mean to be nosy, but I can't remember you using it before. Or maybe I've got it all wrong.

I'm not in need of insulin right now, in fact I've recently taken myself off Metformin (one month experiment to see how this old body reacts) so am depending on LCHF/Keto. However, I am under no illusions about what might change in five or ten years. Fingers crossed.

 

[Tophat1900]

I'm not in need of insulin right now, in fact I've recently taken myself off Metformin (one month experiment to see how this old body reacts) so am depending on LCHF/Keto. However, I am under no illusions about what might change in five or ten years. Fingers crossed.

Thank you for the clarification.

Yeah, one day at a time. Stop and smell the roses.

 

[kokhongw]

I would also like to add that the decades of low carb/keto denial by ADA's panel of experts likely left them with hardly any that has developed sufficient clinical experience with using low carb/keto as a dietary intervention for diabetes.

So any low carb/keto info has to come from elsewhere...

 

[Tophat1900]

I would also like to add that the decades of low carb/keto denial by ADA's panel of experts likely left them with hardly any that has developed sufficient clinical experience with using low carb/keto as a dietary intervention for diabetes.

So any low carb/keto info has to come from elsewhere...

Denial was probably used, thinking it was a fad that could be easily denied in the earlier days and it would simply go away. May be those so called experts grossly under estimated keto/LCHF?

 

[Member496333]

Let's not get carried away. Remission does not mean the same thing as cure and for those of us with severe beta cell dysfunction (or a high level of beta cell death) the very best we can hope for is a long time in remission before more treatment is needed. I just thought a reality check was called for at this point.

You’re probably right in some cases, but on the whole I respectfully disagree. My latest understanding is that in most cases, if the intervention is done properly and for long enough, the pancreas can recover when it is cleared of the fat that is clogging it up. Obviously nothing is black & white in this game, but I certainly don’t agree that “the best we can hope for” is more time. I guess most of us may remain somewhat carbohydrate intolerant, but then if we got diabetes in the first place then we always were.

Anyway I don’t wish to derail, but just wanted to counter your point with a little extra optimism. People are coming off medications and insulin left right and centre. If their pancreas were doomed to fail regardless of dietary intervention, then dawn phenomenon alone would prevent this from being the case as their liver gets carried away with gluconeogenesis unabated.

Only in my opinion

 

[Guzzler]

You’re probably right in some cases, but on the whole I respectfully disagree. My latest understanding is that in most cases, if the intervention is done properly and for long enough, the pancreas can recover when it is cleared of the fat that is clogging it up. Obviously nothing is black & white in this game, but I certainly don’t agree that “the best we can hope for” is more time. I guess most of us may remain somewhat carbohydrate intolerant, but then if we got diabetes in the first place then we always were.

Anyway I don’t wish to derail, but just wanted to counter your point with a little extra optimism. People are coming off medications and insulin left right and centre. If their pancreas were doomed to fail regardless of dietary intervention, then dawn phenomenon alone would prevent this from being the case as their liver gets carried away with gluconeogenesis unabated.

Only in my opinion

There's nothing I can really disagree with except that I feel I must add that we are not all the same i.e some of us were not diagnosed for a very long time and that as we age and as we sometimes develope other conditions the problem can become exacerbated.
This one factoid is one I have heard but only on a single occasion, by the time a person is diagnosed with T2 up to 50% of the beta cells may be dead or dysfunctional. It may be the case (as with the kidneys) that we can survive quite happily on the remaining 50% but only if the appropriate actions are taken.
I am one of life's worriers and I worry about complacency, sometimes.

 

[Member496333]

There's nothing I can really disagree with except that I feel I must add that we are not all the same i.e some of us were not diagnosed for a very long time and that as we age and as we sometimes develope other conditions the problem can become exacerbated.
This one factoid is one I have heard but only on a single occasion, by the time a person is diagnosed with T2 up to 50% of the beta cells may be dead or dysfunctional. It may be the case (as with the kidneys) that we can survive quite happily on the remaining 50% but only if the appropriate actions are taken.
I am one of life's worriers and I worry about complacency, sometimes.

There’s certainly a lot of split opinion on the whole reverse/cure/remission debate. Jason Fung seems to believe that in T2 it’s more about fatty pancreas than beta cell dysfunction. The former of which can be fixed with diet. Speaking only for myself it’s been estimated that I was diabetic for at least 10-12 years based on my symptoms and complications, and I am now clinically no longer diabetic. In my n=1 experiment my pancreas appears to have recovered. Having said that, I don’t put it to the test by eating carbohydrates, but there is no dawn phenomenon or any signs of gluconeogenesis ever raising my sugars notably above baseline.

Anyway, all we can do is the best we know how and keep sharing our experiences and research. I most certainly do not trust any government to do it for me. You’re right to be cautious

 

[kokhongw]

There’s certainly a lot of split opinion on the whole reverse/cure/remission debate. Jason Fung seems to believe that in T2 it’s more about fatty pancreas than beta cell dysfunction. The former of which can be fixed with diet. Speaking only for myself it’s been estimated that I was diabetic for at least 10-12 years based on my symptoms and complications, and I am now clinically no longer diabetic. In my n=1 experiment my pancreas appears to have recovered. Having said that, I don’t put it to the test by eating carbohydrates, but there is no dawn phenomenon or any signs of gluconeogenesis ever raising my sugars notably above baseline.

Anyway, all we can do is the best we know how and keep sharing our experiences and research. I most certainly do not trust any government to do it for me. You’re right to be cautious

The beta-cells loss by the time of diagnosis is quite certain. However, the dysfunction is a combination of beta cells death and insulin resistance. Hence low carb/keto and IF combo would significantly improve insulin sensitivity, but what remains unclear is the rate of beta cells recovery/regneration if any.

 

[Member496333]

My understanding is that it’s not certain at all, and that it may be more about fatty pancreas. Hence my disagreement

Anyway I’m derailing. Apologies.

 

[nickm]

Australian dietitians now promote “healthy fat” An admission that their many decades of “low fat” advice was wrong.
And if anyone needed further evidence of the incompetence of the medical profession, it is their reluctance to conduct research which could show that traditional treatments are inferior. “we don’t have studies [lasting] longer than two or three years” Really? Whose fault is that? For a treatment that has been around for centuries! And used by so many people. No shortage of research on drug treatment though.

 

[Member496333]

The “healthy fat” label that we all correctly use actually concerns me somewhat. I believe the term should be “natural fat”. As the tide turns and it becomes more accepted that fat is good for us, the last thing we need is to leave the door ajar for industry to pedal even more industrial waste oils.

 

[Shellback]

As a type one who has to use insulin I've found that restricting my carb intake enables me to use far less insulin, which has greatly increased my ability to live an active happy life, with fewer hypoglycemic interruptions.

Restricting carbs has also allowed me to maintain a HBA1c in the normal non diabetic range - although I have to inject insulin to achieve it.

I'm not strictly keto because if my blood sugar starts to drop too low I like to fix it with a beer!

 

[BloodThirsty]

There’s certainly a lot of split opinion on the whole reverse/cure/remission debate. Jason Fung seems to believe that in T2 it’s more about fatty pancreas than beta cell dysfunction. The former of which can be fixed with diet. Speaking only for myself it’s been estimated that I was diabetic for at least 10-12 years based on my symptoms and complications, and I am now clinically no longer diabetic. In my n=1 experiment my pancreas appears to have recovered. Having said that, I don’t put it to the test by eating carbohydrates, but there is no dawn phenomenon or any signs of gluconeogenesis ever raising my sugars notably above baseline.

Anyway, all we can do is the best we know how and keep sharing our experiences and research. I most certainly do not trust any government to do it for me. You’re right to be cautious

Although I have been pre and borderline T2D for many years, I have only been keto-ing for 9 months and consequently have limited experience of its application and ultimate benefits.

However, in a relatively short time I believe that I, like yourself, am well on the road to recovery and put it all down to this demonstrably effective regimen.

Your notion that the correct dietary conditions might regenerate beta cells is, for my money, right on the button and you are absolutely correct in surmising that T2D is diet caused and diet cured.