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Anonymous
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janeecee said:The problem is, for the rest of us, we don't have access to the MRI scanners at Newcastle University and we're not part of that study, so we don't really know how much fat we have in our liver and pancreas, nor do we have access to the same range of blood tests. How can we as a laypeople know what metabolic processes are going wrong (or right) at any particular point, and how far along the continuum we are, and most importantly, can we reverse whatever is going on? And if so, how can we tell?
I am not a diagnosed T2 so I don't even have access to regular Hba1c tests. What I can do is test myself with a glucometer, and use my bathroom scales and a tape measure. Prof Taylor says it's all down to losing fat from the liver and pancreas, but how do I know if that is happening. I have very little weight to spare as it is. Since trying to control my BG levels, I have unintentionally dropped a few pounds but with no effect on my BG levels. So, perhaps this means of 'reversing' diabetes isn't going too work for me. Or perhaps it will if I get my BMI down to 18.5, who knows, but that's verging on being unhealthily underweight.
By the definitions used in the ND study, my FBG and Hba1c would not count as 'diabetic' and if a participant had the same FBG and Hba1c as I had at the end of the ND study, they would be considered 'reversed'. So how could I, as someone with postprandial hyperglycaemia but normal fasting levels, and a BMI of 20, apply the key principles of the ND to restore my first phase insulin response?
I did write to Newcastle University to explain my full situation, including my inability to exercise which I feel is a contributory factor, and offered myself as a guinea pig to see if their regime could reverse prediabetes/impaired glucose tolerance but I heard nothing back from them. I didn't even get as much as an automated 'out of the office' reply. Not that I was expecting much, they probably are inundated with enquiries. Still…it would have been good to have been told why the ND regime might have worked for me, or why I may be unsuitable. At this weight, and with a longstanding chronic illness, the DIY Newcastle Diet might not be the right thing to do unsupervised, but I did at least make serious enquiries.
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In fairness to the study and its results, I feel it is important not to lose sight of the caviats stated in the Disucssions section of the 2-years on Reflections paper (I have taken the liberty to number them for clarity) ...
Observations in uncontrolled free-living populations make this study unique and reflect the prospects for what can be achieved beyond the research environment. However, the limitations inherent to this study design must be acknowledged.
1) Firstly, there will have been self-referral bias, with the observations demonstrating proof of principle rather than any estimate of likely reversal rates.
2) The precision of the diagnosis of Type 2 diabetes is uncertain.
3) The inclusion of individuals with maturity-onset diabetes of youth or slow-onset Type 1 diabetes would result in an
underestimation of rates of diabetes reversal using a very low energy diet.
4) The significant degree of heterogeneity in the intervention must also be acknowledged, including the degree of energy restriction (particularly in those who did not use a meal replacement product) and the length of diet period undertaken.
5) Finally, diabetes reversal was mostly based on self-reported, unverified measurements of glycaemic control in the form of capillary blood glucose results, fasting plasma glucose results, HbA1c or oral glucose tolerance tests.
As I said in an earlier blog, I blogged the following question a week ago ..
"Re: Newcastle Diet Experiences
There are, by now, quite a number of people on the site who will have embarked upon the Newcastle Diet plan and/or who have decided to continue with it. It would be interesting to hear what experiences people have had with the diet, what they have done since, whether they would recommend it etc."
It's a pity that no one has, as yet, responded to that particular blog, although it may still be early days for many. It would be useful to hear from people who are perhaps a bit more 'real' to us than the participants in the study.