It happens exactly to me. My weight rapidly increases if I have carbs.
It happens exactly to me. My weight rapidly increases if I have carbs.Well as I said above I fitted all their criteria for remission in terms of weight loss and as soon as I increased carbs more than the very rare occasion it all started to go backwards again. Good luck if you achieve it but seeing as the original Newcastle trials were only about 50% successful I’m not sure I believe the reported conversation claiming 100% success.
What I was told during discussion with the principal investigator is that after the crash-diet phase the remitters resumed eating that was reduced somewhat (so not literally free) but with unrestricted and freely chosen macronutrient composition, and that the remitters maintained their position for the rest of the two-year period - and that not a single one of them went on low carbs. Well, I don’t know what to make of it all, but I’m minded to up my carbs from 125 to 180 for 3 months and see what happens. I suspect my A1c will rise but who knows? Just curious to see if remission life is possible without constant fear of catching sight of a bread crumb or half a bana
I really think they need to do further research to be honest. Once a diabetic, always a diabetic and in remission through low carbing. It cannot be cured, we have a metabolic disorder which is maintained through diet, also for me. I need to stay very active, as I only need to look at a carb and I put weight on.I can tell you that their unswerving belief is that if T2Ds clear out all their ectopic fat soon after diagnosis then most of them will get their A1c below 48 (I know, not the biggest deal) and can keep it there indefinitely by carefully not regaining weight whilst otherwise eating what they like. They would argue that with a well-resurrected pancreas one should not produce excess insulin in response to a high dollop of carbs and therefore should not suffer an adverse effect such as weight regain. I think their view is that if you’ve still not cleared your ectopic fat then keeping your A1c low merely by low carbing is just a “poor man’s kind of remission”, just a trivial demo of the obvious that you won’t get high flames from the fire in your innards simply by desisting from throwing fuel on it, even though it’s still smouldering underneath and will eventually create a crisis. Now I don’t know what the reality is here because the research is still too sparse and low scale. But I may do my own n=1 non-RCT experiment before long.
If that's the case, that it has not been fully published, then it can be kicked right out of the ball park. No one can make an assessment without all the facts. I have a feeling that it is a failure and those who went into remission have now not in control. Its doomed to fail in the first place.I would add that it’s a pity that the complete picture of what the DiRECT remitters were eating during their second year has not been fully published, and may not have been even fully ascertained. This gap so far makes it hard for the rest of us to make an incisive assessment of the trial and of its implications for our own future T2D management. But I may do my own little experiment as I mooted earlier in the thread.
Why do you think that, We all think the same. first thing, is to reduce glucose levels and to do this was to reduce the carbs, by reducing the carbs Glucose levels are reduced and weight loss follows. This has happened to most of us,, therefore a large example of this. Dr Unwin has a lot of success with his diabetic patients. You could always write to him for his input over the matterMmmm … sample size a little on the low side perhaps !
Well let us know how you do. Include the complete break down of what you did and the foods you ate. That would be intesting.The latter para misinterprets my intent, which is to see whether raising carbs will raise my A1c. My weight will remain constant because I will make it so by other adjustments.
Any Ideas what the statistics are now. It is only 2 years, which is not a long time at all. I am 9 years in, which to me is a very long time to stay in remission. I would not follow their recommendations at all. I do not follow the recommendation of needing to eat carbs with every meal by the diabetic nurses.Is this a fair summary of DiRECT? My understanding is that most of those who were in remission at 1 year had remained so at 2 years. This is not “temporary” remission for the majority - so far, anyway.
What also needs acknowledging is that the ND diet used in the study is actually Low Carb and only just above keto for most people. Does not matter which shakes are used, Optifast. Exante, or Cambridge they are low carb.And I too have “low carbed” (125-130g) for (two) years, with A1c stable so far. But with those who have had to keep stepping their carbs ever further down I would be curious to know whether they had not originally cleared their pancreatic fat to the maximum possible and thus had only been living on borrowed time. What does need acknowledging by the low carb believers is that the DiRECT two-year remitters maintained their remission without low carbing at all. This cannot be dodged.
I am simply peer reviewing. Where does Taylor identify a peer review took place? Who reviewed his work? I repeat, the style of reporting his results falls short of what I would expect from an academic institution. As a scientist, you should also feel uncomfortable about this.Of course all scientists get some things wrong and we depend upon experimentation, critique and peer review to tease out the flaws and to make progress. I think you verge on being unkind to Taylor by giving the impression that he commits wilful obscuration or avoidance of inconvenient considerations, or that his many collaborators do also. That doesn’t ring true with me. But your penultimate para hits all the right nails on the head, this has been my exact frustration with that research programme and its reporting to date.
The fundamental observation of the DiRECT investigators is that clearing out the ectopic fat results in hepatic and pancreatic functional normalisation, including first phase response. That is, other than an underlying genetic susceptibility to regaining ectopic fat upon weight regain, one’s position should be as for a non-diabetic, i.e. not having to treat carbs per se as some kind of poison. Well, as I said, I am not certain about all that, but I shall do my 3-month elevated carb experiment to get at least an answer for myself and I will certainly present the outcome and a comprehensive account of the regimen adopted. My hunch is that raising my carbs from 130g to 180g will yield no significant difference, but we will see!I thinl this is relevant, from the DIRECT 2 year follow up
"In a post-hoc analysis of the whole study population, of those participants who maintained at least 10 kg weight loss (45 of 272 with data), 29 (64%) achieved remission; 36 (24%) of 149 participants in the intervention group maintained at least 10 kg weight loss."
The 64% remission group is of the 45 that maintained weight loss, out of the 272 that took part in the DIRECT study.
To be clear here, if you increase your carb intake then do you also reduce your fat and/or protein intake? I mean by amount in g, not by percentage composition?It happens exactly to me. My weight rapidly increases if I have carbs.
Well it is standard practice that the reviewers of journal submissions are not identified to the authors, so we cannot know who reviewed the many papers published by that team.I am simply peer reviewing. Where does Taylor identify a peer review took place? Who reviewed his work? I repeat, the style of reporting his results falls short of what I would expect from an academic institution. As a scientist, you should also feel uncomfortable about this.
You are comparing apples with bananas. as I understand it you are currently low carbing, so your start point for comparison is not the same as most of the ND participants. By all means, experiment. i hardly think 180g carbs is a reflection of unlimited carbs as stated in your OP. It is certainly not gay abandon levels. You will probably see a rise in average bgl levels, so please make sure you track the average daily level. As it happens, I in my n=1 journey eat around 200 g per day with a medium high fat content, and my weight has been pretty static for several years now at 64kg.The fundamental observation of the DiRECT investigators is that clearing out the ectopic fat results in hepatic and pancreatic functional normalisation, including first phase response. That is, other than an underlying genetic susceptibility to regaining ectopic fat upon weight regain, one’s position should be as for a non-diabetic, i.e. not having to treat carbs per se as some kind of poison. Well, as I said, I am not certain about all that, but I shall do my 3-month elevated carb experiment to get at least an answer for myself and I will certainly present the outcome and a comprehensive account of the regimen adopted. My hunch is that raising my carbs from 130g to 180g will yield no significant difference, but we will see!
I agree that my start point is not comparable to the ND position, but it is not my intent to construct any such comparison. I have just the narrow aim of testing whether, from where I stand now, I can up my carbs without detriment. I do already know from previous experimentation that my 3 months on 100g (ending with A1c=42) followed by 3 months on 135g left my A1c virtually unaltered (ending with A1c=40). And I agree that going up to 180g will hardly be radical - but it might allow me some welcome extra latitude. Your 200g is a very good level. I too weigh 64kg.You are comparing apples with bananas. as I understand it you are currently low carbing, so your start point for comparison is not the same as most of the ND participants. By all means, experiment. i hardly think 180g carbs is a reflection of unlimited carbs as stated in your OP. It is certainly not gay abandon levels. You will probably see a rise in average bgl levels, so please make sure you track the average daily level. As it happens, I in my n=1 journey eat around 200 g per day with a medium high fat content, and my weight has been pretty static for several years now at 64kg.
You did not get my point in my last post. The number of people that were in remission at 2 years is only 6.8% of the number that started, and about half of those in remission seem to be control cohort members using medication, not ND dieters off medication.
Indeed so. Given the growing aspiration that GPs should shift much more emphasis towards attempting remission, and given how important it would become to maintaining that, there will need to be much more incisive research done - and widely and reproducibly - on the basis, tactics and assessment of remission, together with write-ups that provide clear data for HCPs and patients alike. I think all of us here who have been discussing this thread are in agreement that we need much better analysis than what can be gleaned from the two dozen or so papers emerging so far from DiRECT. But science is under funding stress, university life is much harder in very many ways than 40 years ago, so we are fortunate that people like Taylor and their impoverished PhD students and postdoc researchers are in the game at all, and we should all be sensitive to that, I suggest. Meanwhile we all plod on with our self-experimentation.@Oldvatr I'm a Taylor advocate but like you I can pick holes in his work.
Before ReTune, before Direct, we had Counterpoint, published back in 2012.
https://eprints.ncl.ac.uk/file_store/production/175328/FA1F5CAA-078D-4CDB-8DC3-49CE08B40C72.pdf
This was the one & only time he ever submitted his successful candidates to a 75g OGTT post remission.
View attachment 57687
I don't know how you could judge these candidates as being in remission, 10.3 @ 2 hours on the gold standard 75g OGTT is very very prediabetic.
No record of where they were @ 1 hour either, perhaps there was no lab draw, perhaps he didn't see fit to publish.
Either way he never repeated this test on any of his follow up studies.
Indeed. It is interesting to note the weight gain in just 12 weeks. As regards remission, Taylor has his own definitopn of remissio that differs from the rest of the world. He ignores prediabetes as being a classification. Also, there was no check on medication use post intervention, and at least some 40% continued to use their diabetic meds. The rest of the world requires remission to be sans medication. and a yearly HbA1c to also be non diabetic.@Oldvatr I'm a Taylor advocate but like you I can pick holes in his work.
Before ReTune, before Direct, we had Counterpoint, published back in 2012.
https://eprints.ncl.ac.uk/file_store/production/175328/FA1F5CAA-078D-4CDB-8DC3-49CE08B40C72.pdf
This was the one & only time he ever submitted his successful candidates to a 75g OGTT post remission.
View attachment 57687
I don't know how you could judge these candidates as being in remission, 10.3 @ 2 hours on the gold standard 75g OGTT is very very prediabetic.
No record of where they were @ 1 hour either, perhaps there was no lab draw, perhaps he didn't see fit to publish.
Either way he never repeated this test on any of his follow up studies.
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