Why won't the NHS tell you the secret to treating diabetes?

[Tannith]

That equates to an average glucose level of 6.5mmol/L. Borderline pre-diabetic and certainly indicates some insulin resistance. No judgement from me, but personally I'd not really call that reversal/remission without more data. A fasting insulin test would fill in the blanks. I would expect it to be elevated with a HbA1c of 39. If not then insulin production likely impaired.

If that is the case, though adequate, it is not perfect. I shall have to lose some more weight to improve it.

 

[kokhongw]

You keep on making this claim with absolutely zero evidence to back it up.

Please stop.. it's patently untrue as ViRTA have shown multiple times with many patients.

I believe her impression comes from the observation made in various studies from Dr Roy Taylor...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399621/

The importance of duration of type 2 diabetes since diagnosis was clear from the Counterbalance dataset, with 60% remission in those with duration <4 years, compared with 21% with duration >8 years.14 Even within the DiRECT study group, which only included people within the first 6 years after diagnosis of type 2 diabetes, those achieving non-diabetic levels of glucose control had a slightly but significantly shorter duration.18

 

[Tannith]

That equates to an average glucose level of 6.5mmol/L. Borderline pre-diabetic and certainly indicates some insulin resistance. No judgement from me, but personally I'd not really call that reversal/remission without more data. A fasting insulin test would fill in the blanks. I would expect it to be elevated with a HbA1c of 39. If not then insulin production likely impaired.

Thank you for your observation. I looked up a conversion chart http://www.wales.nhs.uk/sitesplus/documents/866/HbA1c converter.pdf and it gives a reading of 5.7 FBG as the equivalent of HBa1c of 39. Says its a "DCCT" reading. I'm not sure what that means.It's still not a brilliant level. Is there a standard conversion chart recognised by a reputable national/international body that you know of and could refer me to? It appears some hospital trusts are producing their own and they vary. I shall be starting a low calorie diet immediately to repair my beta cells and want to know what FBG target I should aim for.

 

[Tophat1900]

Apart from those concerned enough about their diabetes to participate in this forum, I wonder how long the public in general would keep to a low carb diet if it was advised by their doctor especially if it was supposed to be for the rest of their life. My DN, who is a low carb enthusiast, told me that a common reaction from her patients was that giving up bread and potatoes was ridiculous. "Haven't you got some pills I can take?" they would say. I imagine the appeal of the Newcastle Diet to the NHS is that patients might find a quick fix more attractive than a change of lifestyle. Whether it works or not is another question.

Yes, for some it is just too hard to give up those foods when you've been eating them all your life. I used to love slapping mashed potatoe on bread and eat it with dinner. Obviously I don't do that anymore. I guess the question is do people understand how these decisions to cut out or cut back on these types of foods or not will impact on their future health, who knows? These people who find it ridiculous to give up bread and potatoes and want pills instead are most likely to be people who have no interest in educating themselves on their own diabetes and are content to just let the medical system make all the decisions for them. And you can't blame them when they are told bread and fruit, pasta, rice are healthy choices by dieticians and so called experts.

The quick fix might be appealing for those who have a lot of weight to lose and here's the magic diet... starvation, followed by support after it because there are still restrictions, portions sizes and calorie counting to be done if a person manages to make it through the shakes and soups part. There isn't a return to normal eating like people may think, they can't go back to eating the way they did or it all falls apart. This part really isn't elaborated on... the focus is on selling the huge weight loss that occurs, which is clever. And is very appealing to people. And any diet that is so very restrictive like ND is going to be hard to stick to. Low carbing however allows a person to eat till they feel full. It's not that hard to follow a diet where you are not left hungry. Low carb also has a good amount of success attached to it and has years of great results and is clearly sustainable. ND can make no such claims.

But, there is money at stake here and vested interests to appease.

 

[Tophat1900]

Thank you for your observation. I looked up a conversion chart http://www.wales.nhs.uk/sitesplus/documents/866/HbA1c converter.pdf and it gives a reading of 5.7 FBG as the equivalent of HBa1c of 39. Says its a "DCCT" reading. I'm not sure what that means.It's still not a brilliant level. Is there a standard conversion chart recognised by a reputable national/international body that you know of and could refer me to? It appears some hospital trusts are producing their own and they vary. I shall be starting a low calorie diet immediately to repair my beta cells and want to know what FBG target I should aim for.

Yes, 5.7 = 39 for Hba1c... the whole chart is for hba1c level conversions.

Where are you seeing FBG? I wouldn't be regarding a FBG level as meaning this is also your HBA!C level.

 

[Mr_Pot]

If that is the case, though adequate, it is not perfect. I shall have to lose some more weight to improve it.

The fact that some much younger carnivores on extremely restricted diets have very low HbA1c doesn't detract from your respectable result. There is no such thing as borderline prediabetic, what level does it start? If you were below that level you would probably be called "very nearly borderline prediabetic" by those who regard achieving a very low HbA1c as some sort of accolade.

 

[Tannith]

Yes, 5.7 = 39 for Hba1c... the whole chart is for hba1c level conversions.

Where are you seeing FBG? I wouldn't be regarding a FBG level as meaning this is also your HBA!C level.

Thank you for your help Tophat. I had misunderstood that the equivalents were between new and old measurements of HbA1c rather than equivalents between HbA1 c and FBG. I am new to these HbA1c tables and measurements and was only familiar with the IFCC mmol/mol ones. Thank you for enlightening me.

 

[bulkbiker]

Thank you for your observation. I looked up a conversion chart http://www.wales.nhs.uk/sitesplus/documents/866/HbA1c converter.pdf and it gives a reading of 5.7 FBG as the equivalent of HBa1c of 39. Says its a "DCCT" reading. I'm not sure what that means.It's still not a brilliant level. Is there a standard conversion chart recognised by a reputable national/international body that you know of and could refer me to? It appears some hospital trusts are producing their own and they vary. I shall be starting a low calorie diet immediately to repair my beta cells and want to know what FBG target I should aim for.

From here on this very site
https://www.diabetes.co.uk/hba1c-units-converter.html

 

[zand]

@Tannith please be careful not to overdo the low calorie diet. Your figures are still very good. I understand your aim is to be free of T2 through regeneration of your beta cells, but remember we aren't just diabetic, there's the rest of your health to think about.

 

[Member496333]

Thank you for your observation. I looked up a conversion chart http://www.wales.nhs.uk/sitesplus/documents/866/HbA1c converter.pdf and it gives a reading of 5.7 FBG as the equivalent of HBa1c of 39. Says its a "DCCT" reading. I'm not sure what that means.It's still not a brilliant level. Is there a standard conversion chart recognised by a reputable national/international body that you know of and could refer me to? It appears some hospital trusts are producing their own and they vary. I shall be starting a low calorie diet immediately to repair my beta cells and want to know what FBG target I should aim for.

39 mmol/mol HbA1c = 5.7% = average glucose 6.5 mmol/L

https://www.hba1cnet.com/hba1c-calculator/

 

[Member496333]

The fact that some much younger carnivores on extremely restricted diets have very low HbA1c doesn't detract from your respectable result. There is no such thing as borderline prediabetic, what level does it start? If you were below that level you would probably be called "very nearly borderline prediabetic" by those who regard achieving a very low HbA1c as some sort of accolade.

Borderline pre-diabetic means diabetic pathology and likely elevated fasting insulin. The lines in the sand are diagnostic criteria only, as everything is a sliding scale of severity. No one is judging anyone. We decide for ourselves what we are happy with, but the subject of insulin production is pertinent to the conversation of beta cell function.

 

[Member496333]

Thank you for your help Tophat. I had misunderstood that the equivalents were between new and old measurements of HbA1c rather than equivalents between HbA1 c and FBG. I am new to these HbA1c tables and measurements and was only familiar with the IFCC mmol/mol ones. Thank you for enlightening me.

Also remember that FBG is just a one-shot fasting measurement. Not the same as a calculation of average glucose taken from HbA1c. And HbA1c in itself is only an estimate, since it's an indirect measurement and prone to error.

EDIT: Time in target is actually the very most accurate measure of glucose, but requires an expensive CGM habit in order to maintain for any length of time.

 

[Tannith]

39 mmol/mol HbA1c = 5.7% = average glucose 6.5 mmol/L

https://www.hba1cnet.com/hba1c-calculator/

Thank you. And thank you BB too. I hadn't found these triple converters that convert to both HBa1c in DCCt and further in FBG. I'd never had cause to use them before Jim L pointed out that my 39 HBa1C was really quite high when translated into FBG. And as I'd been only vaguely aware that there were 2 ways of measuring HBa1C I'd never looked it up. Now I know that my equivalent is 6.5 I shall (indeed already have, this lunchtime) start VLCD.

 

[Member496333]

Thank you. And thank you BB too. I hadn't found these triple converters that convert to both HBa1c in DCCt and further in FBG. I'd never had cause to use them before Jim L pointed out that my 39 HBa1C was really quite high when translated into FBG. And as I'd been only vaguely aware that there were 2 ways of measuring HBa1C I'd never looked it up. Now I know that my equivalent is 6.5 I shall (indeed already have, this lunchtime) start VLCD.

To reiterate, there is no calculation to FBG. FBG is a real, one-time, direct measure of fasting glucose. But again there will be inaccuracies in any testing equipment. The calculation here is to mean average glucose. An estimated average based on HbA1c. It can also be estimated using historical pin prick data.

 

[lucylocket61]

Thank you. And thank you BB too. I hadn't found these triple converters that convert to both HBa1c in DCCt and further in FBG. I'd never had cause to use them before Jim L pointed out that my 39 HBa1C was really quite high when translated into FBG. And as I'd been only vaguely aware that there were 2 ways of measuring HBa1C I'd never looked it up. Now I know that my equivalent is 6.5 I shall (indeed already have, this lunchtime) start VLCD.

Is VLCD refering to a very low carb diet? Because that's all you need. Lower carbs.

Read up about how lowering Cal's too much, or for to long can reset your metabolism, resulting in the need for further calorie reduction in the future to avoid weight gain.

@Brunneria , I think, knows more about this. It's why so many regain weight after dieting.

How much excess weight do you have still?

 

[Tannith]

Is VLCD refering to a very low carb diet? Because that's all you need. Lower carbs.

Read up about how lowering Cal's too much, or for to long can reset your metabolism, resulting in the need for further calorie reduction in the future to avoid weight gain.

@Brunneria , I think, knows more about this. It's why so many regain weight after dieting.

How much excess weight do you have still?

VLCD means very low calorie diet. Thank you for the warning about lowering metabolism. I know this happens but it is a necessary evil in this case. I shall certainly take a holiday from VLCD over Christmas.Probably not allowed on VLCD but I'm doing it anyway! I shan't know how much excess weight I have til I test low enough for FBG. At that point I shall have lost enough. Lower carbs diet would only lower my FBG for as long as I stuck to it. As soon as I ate any amount of carbs my FGB would shoot back up again.

 

[lucylocket61]

VLCD means very low calorie diet. Thank you for the warning about lowering metabolism. I know this happens but it is a necessary evil in this case. I shall certainly take a holiday from VLCD over Christmas.Probably not allowed on VLCD but I'm doing it anyway! I shan't know how much excess weight I have til I test low enough for FBG. At that point I shall have lost enough. Lower carbs diet would only lower my FBG for as long as I stuck to it. As soon as I ate any amount of carbs my FGB would shoot back up again.

I am struggling to understand. Are you saying you think losing the weight will permanently cure your propensity for type 2 diabetes whereas low carbing just controls it? I am asking in good faith. I am genuinely not sure I understand your thinking.

another question - you seem to be saying that your final weight depends on your fbg? Have I understood you in this? Medically speaking, what is your current BMI?

I cant help thinking your are not taking on board the risk of starvation mode, or the risk of continuing to diet to the point of being too thin, in the mistaken idea that if you only lose enough weight, your risk of diabetes will go. Have I misunderstood you?

 

[zand]

I am struggling to understand. Are you saying you think losing the weight will permanently cure your propensity for type 2 diabetes whereas low carbing just controls it? I am asking in good faith. I am genuinely not sure I understand your thinking.

another question - you seem to be saying that your final weight depends on your fbg? Have I understood you in this? Medically speaking, what is your current BMI?

I cant help thinking your are not taking on board the risk of starvation mode, or the risk of continuing to diet to the point of being too thin, in the mistaken idea that if you only lose enough weight, your risk of diabetes will go. Have I misunderstood you?

@Tannith I agree with Lucy. I believe this is where Professor Taylor's research causes more harm than good. I understand your faith in him as after all, the ND has helped you to come to a good place with your BGs, but please remember that very few actually get a real lasting cure from type 2. Even Professor Taylor can get things wrong, listen to others too.

To diet so hard that you become underweight will affect your health in other ways. It is quite possible that your pancreas has simply aged with the rest of your body and just can't deal with carbs as well as you would like. In other words, T2 was never your fault, it wasn't because you were too fat, it just happened. If you follow a VLcal diet for too long then it's possible that your thyroid will be damaged eventually. Also if you are not reducing carb calories but reducing fat instead then gallstones are a possibility. I know people who have developed both of these problems through harsh dieting.

I am pleased to hear that you won't be following a VLcal diet over Christmas, I was worried you were becoming addicted to dieting. Please consider changing to low carb instead of low cal. Nourish your body and look after it, don't starve it.

 

[Tannith]

@Tannith I agree with Lucy. I believe this is where Professor Taylor's research causes more harm than good. I understand your faith in him as after all, the ND has helped you to come to a good place with your BGs, but please remember that very few actually get a real lasting cure from type 2. Even Professor Taylor can get things wrong, listen to others too.

To diet so hard that you become underweight will affect your health in other ways. It is quite possible that your pancreas has simply aged with the rest of your body and just can't deal with carbs as well as you would like. In other words, T2 was never your fault, it wasn't because you were too fat, it just happened. If you follow a VLcal diet for too long then it's possible that your thyroid will be damaged eventually. Also if you are not reducing carb calories but reducing fat instead then gallstones are a possibility. I know people who have developed both of these problems through harsh dieting.

I am pleased to hear that you won't be following a VLcal diet over Christmas, I was worried you were becoming addicted to dieting. Please consider changing to low carb instead of low cal. Nourish your body and look after it, don't starve it.

Jim Lahey pointed out that my Hba1c is the equivalent of 6.52, with the help of the conversion table he recommended. And that this is poor. I have only tables online to go by. This site says:
"The following results indicate the presence of prediabetes:

• Fasting plasma glucose: 5.5 mmol/L to 6.9 mmol/L"
• which means my HBa1c shows I am pre diabetic. That was a bit of a wake up call as I thought I had got my FBG down sufficiently, but obviously I had not.
• Despite constantly banging on about ND in order to make sure plenty of people know how it works, and more importantly that there is a limited window of opportunity for using it, I absolutely hate the process of actually doing it. I would not recommend it because it is easy - I found it really hard- but because for many it works so well. Rest assured I am in no danger of becoming addicted to dieting! Just to getting rid of my T2

 

[Tannith]

I am struggling to understand. Are you saying you think losing the weight will permanently cure your propensity for type 2 diabetes whereas low carbing just controls it? I am asking in good faith. I am genuinely not sure I understand your thinking.

another question - you seem to be saying that your final weight depends on your fbg? Have I understood you in this? Medically speaking, what is your current BMI?

I cant help thinking your are not taking on board the risk of starvation mode, or the risk of continuing to diet to the point of being too thin, in the mistaken idea that if you only lose enough weight, your risk of diabetes will go. Have I misunderstood you?

"Are you saying you think losing the weight will permanently cure your propensity for type 2 diabetes whereas low carbing just controls it? " Yes, more or less. Although I don't think it's a permanent cure exactly, as obviously it can come back if you regain the weight. Or in my case, some of it. IMO My risk of diabetes will certainly not go away. It will always be there if I regain weight above my personal fat threshold.