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

[zand]

You don't think your extraordinarily massive weight loss (8 stone) might be the reason you have low BG? Anyone losing anywhere near that much weight pretty well MUST have lost the excess weight from their pancreas?

And how did he lose that weight? Gosh by going low carb!

 

[Tannith]

I'm afraid @Tannith this holy grail you seek might not exist.

We know that in Taylor's 2 year follow up that maximal insulin secretion had increased to a rate comaprable to a non-diabetic control group. What is often missed in the small print is that their 1st phase insulin response was only 50% of the same control group, even @ 2 years post remission.
https://pubmed.ncbi.nlm.nih.gov/32060017/
Whether this deficency is down to signaling pathways, poor beta cell secretion rates or lack of insulin sensitivity is not explored.

This expains the large spikes often seen in pre-diabetic & diabetics after a carb load. Whether this 1st phase can be fully repaired has not yet been proven.

I don't need it to be fully repaired. Just to close to the normal range would suit me fine. Elsewhere (& I can't find it at the moment but in another description of the same study) he say s that 2nd phase insulin response ( the 2hour one) goes from approx 45% of the normal cohort's to approx 92% of it. That will do me. Simply lowering blood sugar is a goal I would only seek if all else had failed, as it treats the symptoms of T2 not the cause. And I would do it with metformin if no serious side effects, to avoid the risk of excess unhealthy fats. Edited to add PS Furthermore, when compared to a nondiabetic comparator (NDC) group used in the study, which matched the age/gender of the DiRECT intervention group participants after weight loss, the study participants’ maximum rate of insulin secretion was comparable. The intervention group participants’ insulin secretion increased from a median of 0.58 nmol/min/m2 at baseline to 0.94 nmol/min/m2 after two years, and the insulin secretion of the NDC group had a median insulin secretion rate of 1.02 nmol/min/m2 at 24-months follow up.
https://www.diabetes.org/newsroom/press-releases/2019/insulin-producing-beta-cells

 

[Tannith]

Oh for goodness sake you are missing the point.
You want to lose weight to reach your PFT. You can do this by following low carb. The advantage of low carb is that you dont have to starve yourself to do this.

You can ONLY lose weight with low carb if you use it as a low cal diet. If you don't replace the missing carbs with extra calories from fat then of course you reduce your calories and lose weight. But simply changing the macronutrient from which you derive your calories cannot cause weight loss, only lower BG.

 

[Resurgam]

You can ONLY lose weight with low carb if you use it as a low cal diet. If you don't replace the missing carbs with extra calories from fat then of course you reduce your calories and lose weight. But simply changing the macronutrient from which you derive your calories cannot cause weight loss, only lower BG.

That was not my experience.
I have been pushed to eat low calorie many times and it never worked well. I just went pale, cold and tended to collapse if I exerted myself. Eating far more calories but from sources other than carbs enabled me to lose weight and keep doing my normal activities. Something I've experienced many times.

 

[zand]

You can ONLY lose weight with low carb if you use it as a low cal diet. If you don't replace the missing carbs with extra calories from fat then of course you reduce your calories and lose weight. But simply changing the macronutrient from which you derive your calories cannot cause weight loss, only lower BG.

Rubbish. You simply don't understand and you aren't listening. I increased my calories and lost weight. Our bodies are carb intolerant and work better when we reduce them. I already gave you a link to my fat fast where I lost weight having over 2000 cals a day, mostly from fat.

 

[lucylocket61]

You can ONLY lose weight with low carb if you use it as a low cal diet. If you don't replace the missing carbs with extra calories from fat then of course you reduce your calories and lose weight. But simply changing the macronutrient from which you derive your calories cannot cause weight loss, only lower BG.

Not in my experience.

 

[bulkbiker]

You don't think your extraordinarily massive weight loss (8 stone) might be the reason you have low BG? Anyone losing anywhere near that much weight pretty well MUST have lost the excess weight from their pancreas?

And the OGTT? I see you have no answer to that?
Without carbing up beforehand.. according to your belief that should be impossible.

 

[Hotpepper20000]

You can ONLY lose weight with low carb if you use it as a low cal diet. If you don't replace the missing carbs with extra calories from fat then of course you reduce your calories and lose weight. But simply changing the macronutrient from which you derive your calories cannot cause weight loss, only lower BG.

That is such a out dated opinion.
I think you fundamentally don’t understand the nature of diabetes and seem to be stuck
It not just how many calories but how a body reacts. When I eat grains and root vegetables my BG spikes, this increases the insulin in my body. As a result even if I eat low calorie I won’t be able to loose weight because insulin is a fat storing hormone.

When I eat food that keeps my BG steady I can eat more and not gain but loose weight because I have controlled the amount of insulin in my body.

 

[Oldvatr]

@Tannith you and I have crossed swords many times in the past. I disagreed with you then, and I still disagree with you now. I see you have managed to delude yourself again, which is ok and not a problem for me, but here you write as if you have authority, which sadly you do not. None of the sources you cite has been put to proper scientific study with the exception of Roy Taylor's work. The ND diet did have some success, as you quote here, but there is growing evidence that the claimed remission is not long-lived, and requires repeat applications to act as a medical intervention. Your personal experience seems to confirm this.

Repeated use of ultra-low calorie diets is still recognised as being dangerous and harmful if used over prolonged periods. They can be used quite easily as a short sharp shock but use after 8 weeks is not recommended at all.

 

[HSSS]

Low cal is not the same as low carb. The two are "methods" of doing two totally different things. Low cal can reverse T2 whereas low carb can only lower blood sugar, (which can also be done with drugs like metformin). I am looking to REVERSE my T2. Just temporarily lowering blood sugar is not my goal. And the OGT measures beta cell function because it measures the body's SPEED of response to glucose, rather than just the total amount of glucose you have put into your blood by swallowing it (or not swallowing it, as in the case of low carb)

I never claimed they were the same thing.
Low carb reduces insulin resistance which is reversing your type 2. You repeatedly do not see/accept this fundamental point
I understand OGTT thanks. I’m not sure what point you are making here.

 

[HSSS]

You can ONLY lose weight with low carb if you use it as a low cal diet. If you don't replace the missing carbs with extra calories from fat then of course you reduce your calories and lose weight. But simply changing the macronutrient from which you derive your calories cannot cause weight loss, only lower BG.

Absolutely false and wrong. I’ve no idea why you cling to this.

Using low carb and keto, many have maintained or even increased calories but changed the macros and lost weight, reduced blood sugars AND improved our second stage insulin response and insulin resistance and ability to pass an OGTT.

I’ll bow out again now unless you post more inaccurate information as fact.

 

[Tannith]

That is such a out dated opinion.
I think you fundamentally don’t understand the nature of diabetes and seem to be stuck
It not just how many calories but how a body reacts. When I eat grains and root vegetables my BG spikes, this increases the insulin in my body. As a result even if I eat low calorie I won’t be able to loose weight because insulin is a fat storing hormone.

When I eat food that keeps my BG steady I can eat more and not gain but loose weight because I have controlled the amount of insulin in my body.

Of course you need insulin to store calories as fat. But no amount of insulin can cause you to store a single calorie that you haven't first eaten. And even then you could only store it if it was in excess of your daily calorie requirements.

 

[Tannith]

Absolutely false and wrong. I’ve no idea why you cling to this.

Using low carb and keto, many have maintained or even increased calories but changed the macros and lost weight, reduced blood sugars AND improved our second stage insulin response and insulin resistance and ability to pass an OGTT.

I’ll bow out again now unless you post more inaccurate information as fact.

While you're out, I suggest you find a 12 year old, borrow their basic general science textbook and revise the First Law of Thermodynamics.

 

[lucylocket61]

if it was in excess of your daily calorie requirements.

no, sorry. This is not how it works in type 2 diabetics like me. Thats why we put on weight.

First Law of Thermodynamics.

even if this were true, which is disputed, this does not apply to those with insulin resistance and impairment.

The whole point is that you are diabetic. Your mechanism is flawed and you are carb intolerant, so what may work for non-diabetic is irrelevant and not applicable to us.

I am bowing out as there is no more to say. You either accept that your body is no longer able to process carbs in the same way as before becoming diabetic, or you dont.

Discussing this with you is like talking to someone promoting the benefits of milk while also being lactose intolerant, or the nutritious uses of wheat to someone with a gluten intolerance. What is true for those who are not intolerant is not true for those who are.

 

[Mike d]

52,000 collective posts by members I completely respect @Tannith ... I find myself questioning your motives sometimes in the face of all that wisdom.

 

[Hotpepper20000]

While you're out, I suggest you find a 12 year old, borrow their basic general science textbook and revise the First Law of Thermodynamics.

No need to be rude.
How about a little respect for those who are trying to help you and make your life a little easier.
You seem to feel you are right about what you think and nothing we say will change that. But you can debate with a little more class.

 

[zand]

You can ONLY lose weight with low carb if you use it as a low cal diet. If you don't replace the missing carbs with extra calories from fat then of course you reduce your calories and lose weight. But simply changing the macronutrient from which you derive your calories cannot cause weight loss, only lower BG.

Someone should tell my body this. It doesn't agree with you at all. Increase the calories, ditch the carbs and the weight comes off. It obviously hasn't read the same text books as you and yours.

 

[Oldvatr]

While you're out, I suggest you find a 12 year old, borrow their basic general science textbook and revise the First Law of Thermodynamics.

You and the nutritionista assume that every mote of food that goes through your mouth gets used to produce energy. using Joules Law 1 kcal = 4,200 joules. But this does not take into account the filters in our bodies that use or reject nutrients, and also assumes that the food we do absorb gets converted into energy-efficient forms The food gets converted from one form to another in the body, which by itself uses a lot of energy which again is not allowed for in the simple formulae used by food manufacturers. In other words, there is no measurement in vivo but an estimate of what a bomb calorimeter once measured in the lab on single ingredients one at a time.

What is stated on the packet is at best a rough guesstimate of potential energy in the ingredients, not the meal as a whole. Different people process this in different ways, and what comes out as rejected material also differs. It is like saying that a jerry can of petrol will make a car drive for x miles, without taking in to account its octane value and the engine efficiencies. or even the weight of the car and passengers or the prevailing wind direction. Cars tend to go further when going downhill. Not sure what happens when I go downhill. Wonder what my mpg is. (metres per gutful)

I am carb intolerant, which means I do not process carbs as efficiently as I should. The lab lookup tables are not calibrated for me.

 

[Beating-My-Betes]

You and the nutritionista assume that every mote of food that goes through your mouth gets used to produce energy. using Joules Law 1 kcal = 4,200 joules. But this does not take into account the filters in our bodies that use or reject nutrients, and also assumes that the food we do absorb gets converted into energy-efficient forms The food gets converted from one form to another in the body, which by itself uses a lot of energy which again is not allowed for in the simple formulae used by food manufacturers. In other words, there is no measurement in vivo but an estimate of what a bomb calorimeter once measured in the lab on single ingredients one at a time.

What is stated on the packet is at best a rough guesstimate of potential energy in the ingredients, not the meal as a whole. Different people process this in different ways, and what comes out as rejected material also differs. It is like saying that a jerry can of petrol will make a car drive for x miles, without taking in to account its octane value and the engine efficiencies. or even the weight of the car and passengers or the prevailing wind direction. Cars tend to go further when going downhill. Not sure what happens when I go downhill. Wonder what my mpg is. (metres per gutful)

I am carb intolerant, which means I do not process carbs as efficiently as I should. The lab lookup tables are not calibrated for me.

It still comes down to calories in vs calories out. The reason it seems otherwise is because people mistake calories in as being measured at our mouths. But in reality, both calories in and out are a 'bottom-line' equation. After all the questions of satiety, dietary compliance, nutrient absorption/malabsorption and whether the body ramps up metabolism, increases heat or forces us to fidget via N.E.A.T, to burn any excess energy off, one is left with a number that is balanced against our actual/real caloric expenditure. An energy deficit will lead to needing to borrow from stored energy (fat and muscle bank), and an excess will allow one to make an energy deposit, to be used for another time.

Because we can't accurately measure the absolute calories in food, nor the energy that is lost through the various processes and inconsistencies, or the fact that us lay people certainly can't accurately measure our caloric expenditure (not to mention that none of this is neatly calcualated by the body in 24-hour time packages), it can seem like calories in/out does not compute. But Tannith is right when referring to thermodynamics. These are unbreakable laws of energy. Which is fortunate, because we'd never have survived as a species were it not for our ability to store and burn excess energy, at the appropriate times.

 

[Oldvatr]

It still comes down to calories in vs calories out. The reason it seems otherwise is because people mistake calories in as being measured at our mouths. But in reality, both calories in and out are a 'bottom-line' equation. After all the questions of satiety, dietary compliance, nutrient absorption/malabsorption and whether the body ramps up metabolism, increases heat or forces us to fidget via N.E.A.T, to burn any excess energy off, one is left with a number that is balanced against our actual/real caloric expenditure. An energy deficit will lead to needing to borrow from stored energy (fat and muscle bank), and an excess will allow one to make an energy deposit, to be used for another time.

Because we can't accurately measure the absolute calories in food, nor the energy that is lost through the various processes and inconsistencies, or the fact that us lay people certainly can't accurately measure our caloric expenditure (not to mention that none of this is neatly calcualated by the body in 24-hour time packages), it can seem like calories in/out does not compute. But Tannith is right when referring to thermodynamics. These are unbreakable laws of energy. Which is fortunate, because we'd never have survived as a species were it not for our ability to store and burn excess energy, at the appropriate times.

If our bodies were simplistic mechanical devices, then I might agree with you, but our bodies have an innate intelligence that regulates all the processes in our bodies better than the computers in the Space Shuttle. While our food transits the intestines and colon, our body controls how and when it collects nutrients from the gut and usually this process is responding to another set of demand./ saity enzymes that alter what we accept from the food stream. Most of our meal appears at the other end and gets discarded. We know this contains the macronutrients from the meal since it can be placed into a sludge digester and produce methane which we can burn for energy, It also can be used as a fertilizer so has other nutrients still in the mix that did not get grabbed. So the calories-in does not represent what actually gets passed into our body for use.

We have now established that this is true of glucose, and also for lipids, so that fat in does not usually equal fat gain for example. If it did then I would be severely obese instead of skinny. I eat a high-fat diet, but my weight has been static for 5 years now and my BMI is 21. I am a pensioner who is a couch potato in lockdown, but my mass is still unchanging whereas the CICO mantra states I should be ballooning. I used to weigh nearly 17 stone, but after I started LCHF for my blood glucose control, I have dropped to 10 stone and stay there within 1 kg. My wife shared my diet, and she dropped from 18 stone to just over 9 stone at the same time. My waist lost 6 inches of girth as a result. So for me, Low Carb lost weight and gave me control of my BGL. I have never counted a calorie in my life. I do not even count carbs and I do not starve myself.