Dec 2014 update: New research on the Low Carb Diet in general practice

[Southport GP]

Looking through the forum I was sorry to hear how some of you met a rather closed response from your health professionals .About two years ago I began working with a group of 19 pre-diabetic and type two diabetic patients (insulin dependent patients were not included) who were interested in maximizing the benefits of a good diet and wanted to try a lower carb, higher fat diet. I thought if I could get the work published by a reputable peer reviewed journal you would then have something to share with your doctors, nurses and dieticians. I am particularly interested in the goal of maximizing the effect of diet BEFORE starting medication and find many patients agree.

THE RESULTS : Weight and HbA1c down significantly ,also improvements in blood pressure, liver function tests and interestingly cholesterol despite a diet higher in fats (coconut oil ,butter, olive oil and lots of eggs) Over the last year I have come to feel that the starch in bread, pasta (even whole meal) rice and potatoes is actually concentrated sugar, with a higher glycemic index than table sugar itself. So no surprise that diabetics may struggle to deal with these items in their diet. It seems to me that HOWEVER any particular overweight patient looses weight their Type 2 diabetes improves. This can lead to some rather stark choices between weight loss and medication!

Update march 24/03/2014; find the full article free to view here;
http://www.practicaldiabetes.com/Sp.../March 2014/PP Unwin final proofs revised.pdf
The idea is that you can also show it to health care professionals involved to show them its a valid choice of diet

Update two; 26/12/2014; how are we doing after a year on the diet?

The success of this small pilot enabled us to get a grant from the Southport CCG to run nurse-led evening clinics and extend the low carb approach.
Now after an average of a year on the low-carb diet the number of type 2 diabetics in the cohort has increased from 19 to 31, the average weight loss is still 9.113 Kg (95% confidence interval of this difference: From 6.569 to 11.656) with a mean drop in HbA1c of 8.482mmol/mol (95% confidence interval of this difference: From 2.079 to 14.88) None of the patients who gave up metformin have needed to re start it either.
Coming up next -The liver and low carbing, very nearly ready for publication
Please find more detail in my Dec 2015 Diabesity in Practice article free to view here;
http://www.diabesityinpractice.co.uk/media/content/_master/3963/files/pdf/dip3-4-131-4.pdf

One way or another we have all eaten our way into this diabesity epidemic, this has been my way to help patients eat their way out of it again!

Going 'online' is as a GP has some dangers which is why I must point out it's not really ethical for a doctor to give specific advice so I cannot answer questions relating to an individual case -sorry. My hope was that the work could help inform the debate between people with diabetes and the health professionals who care for them.

And finally.., I just want to say how much I have learnt from the clever folk on this great blog. Thanks!!

 

[paul-1976]

LCHF has been a saviour to me and many others,It's so refreshing to see another HCP with blue sky thinking and that is prepared to go against the old dogma on dietary advice for diabetics and put their head above the parapet so to speak.

I for one,look forward to your posts,now and in the future.

Paul

 

[Madbazoo]

Looking through the forum I was sorry to hear how some of you met a rather closed response from your health professionals .About a year ago I began working with a group of 19 pre-diabetic and type two diabetic patients (insulin dependant patients were not included) who were interested in maximising the benefits of a good diet and wanted to try a lower carb, higher fat diet. I thought if I could get the work published by a reputable peer reviewed journal you would then have something to share with your doctors,nurses and dieticians. I am particularly interested in the goal of maximising the effect of diet BEFORE starting medication and find many patients agree.
I have just heard the work is to be published in March. The idea is that after the article is published by Practical Diabetes it will be free to view for you all

THE RESULTS : Weight and HbA1c down significantly ,also improvements in blood pressure,liver function tests and interestingly cholesterol despite a diet higher in fats (coconut oil ,butter,olive oil and lots of eggs) Publication is due in a few weeks will see then if I can upload an abstract and a link to the entire thing. Over the last year I have come to feel that the starch in bread, pasta (even whole meal) rice and potatoes is actually concentrated sugar, with a higher glycemic index than table sugar itself. So no surprise that diabetics may struggle to deal with these items in their diet. It seems to me that HOWEVER any particular patient looses weight their diabetes improves. This can lead to some rather stark choices between weight loss and medication!

Going 'online' has its pitfalls. last year my children thought it was hilarious that some of you thought I was a troll, that has now been sorted out. Another is that it's not really ethical for a doctor to give specific advice which is why I cannot answer questions relating to an individual case -sorry. My hope was that the work could help inform the debate between people with diabetes and the health professionals who care for them.

I am sure we will all look forward to reading it. Thanks for letting us know.


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[carraway]

I will look forward to reading it too.

I think some GPs are just to afraid to say boldly ' You are too fat to be healthy!'

Cara

 

[Southport GP]

Yes , for years I struggled with commenting on people's weight in case that upset them, more recently I find many people are more open to the choices that are theirs to make with diet and lifestyle

 

[douglas99]

..................starch in bread, pasta (even whole meal) rice and potatoes is actually concentrated sugar, with a higher glycemic index than table sugar itself...................

I will be waiting to see the study that shows that, as I always test, and my meter certainly had a worse result for white sugar than basmati rice, and if you claim you can prove the opposite, I may have to be back on white sugar instead! Bookmarked this thread!

 

[Signs]

I too weaned myself of gliclazide and now control my numbers by eating a low carb diet. Look forward to reading your paper.

 

[douglas99]

I went for portion controlled, calorie counting, I lost 4 stone, and now have normal bs readings. I obviously want to continue with my resultse, so if a lchf have a decent trial against this, it's going to be an interesting read. Normally it's extremes of both lf, and lc that are spun out by the media, so a decent clinical trail against a "normal" control group is going to be worth seeing.

 

[Beachbag]

Ooo, I smell a HUGE breath of fresh air! and look forward to reading your findings.....I low carb, but am T2 ID and note that my category was excluded. Still hoping for some relevance though

 

[Charles Robin]

I look forward to reading the results, thanks for the positive post!

 

[douglas99]

The interesting thing for me will be the olive oil/butter.
I'm very keen to target my cholesterol, and I want to look at the unsaturated/saturated fats arguments.

 

[Westie2]

Thank you for posting, I look forward to reading the final article. It will be good to stimulate discussion and hopefully this will lead to a multi centre study allowing monitoring of groups who receive 'normal' care and those following a low carb/carb aware diet. The challenge will of course be to counter trial bias. (By this I mean patients on clinical trials frequently respond due to the placebo effect, see Horizon on BBC2 now, where the additional monitoring can show an improvement from baseline.)



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[modesty007]

Looking through the forum I was sorry to hear how some of you met a rather closed response from your health professionals .About a year ago I began working with a group of 19 pre-diabetic and type two diabetic patients (insulin dependant patients were not included) who were interested in maximising the benefits of a good diet and wanted to try a lower carb, higher fat diet. I thought if I could get the work published by a reputable peer reviewed journal you would then have something to share with your doctors,nurses and dieticians. I am particularly interested in the goal of maximising the effect of diet BEFORE starting medication and find many patients agree.
I have just heard the work is to be published in March. The idea is that after the article is published by Practical Diabetes it will be free to view for you all

THE RESULTS : Weight and HbA1c down significantly ,also improvements in blood pressure,liver function tests and interestingly cholesterol despite a diet higher in fats (coconut oil ,butter,olive oil and lots of eggs) Publication is due in a few weeks will see then if I can upload an abstract and a link to the entire thing. Over the last year I have come to feel that the starch in bread, pasta (even whole meal) rice and potatoes is actually concentrated sugar, with a higher glycemic index than table sugar itself. So no surprise that diabetics may struggle to deal with these items in their diet. It seems to me that HOWEVER any particular patient looses weight their diabetes improves. This can lead to some rather stark choices between weight loss and medication!

Going 'online' has its pitfalls. last year my children thought it was hilarious that some of you thought I was a troll, that has now been sorted out. Another is that it's not really ethical for a doctor to give specific advice which is why I cannot answer questions relating to an individual case -sorry. My hope was that the work could help inform the debate between people with diabetes and the health professionals who care for them.

Get in touch with dietdoctor - Andreas Eenfeldt (Swedish GP with special interest in diet, and diabetes), he'll be happy tospread world all over Scandinavia and further.

 

[DiamondAsh]

Thank you for being an open minded GP and touching base with us here.

 

[Squire Fulwood]

Looking through the forum I was sorry to hear how some of you met a rather closed response from your health professionals .

Understatement of the week but refreshing to know that at least one GP has noticed.

My most recent results are in my signature and they demonstrate what happened when I gave up the pills and improved my diet.

 

[Mrs Vimes]

I am a type 1 who went lchf in August 13. I've list almost 4 stone. My peaks and troughs are so much less extreme.
The best is knowing I am not going to go low because I've overcompensated for a bowl of pasta.
I miss toast but other than that I feel the best I've ever felt and my last hba1c was 6.5% in old money. Hoping to beat that I. The next one. I also know that it wasn't based on massive highs and dangerous lows.

Look forward to hearing about your research. (I'm also from Sefton!)
Mrs Vimes


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[AnnieC]

I would be interested to know if all the 19 people in the trial needed to loose weight or were there any who didn't need to loose.
Most of the talk on here is from people who low carb but also needed to loose weight so us skinnies are very much in the minority if LCHF made us loose more weight this would not be good. Did the trial show what was the best level of carbs to consume as people here vary a lot in how many they eat in a day

 

[Andy12345]

I'm no expert but i don't believe you will lose weight on lchf if your already skinny, for me anyway the weight loss has just stopped when it decided i was about right, it fell off then just stopped falling off, so i reckon theres no reason to accidentally lose weight on lchf otherwise i would have continued losing it

 

[AnnieC]

Yes Andy I don't really know if I went LCHF if I would loose any more weight but there does not seem to be any statistics or information at all as to how LCHF affects people who do not need to loose weight I have read plenty on here from the low carbers who needed to loose weight but not read anything from a low carber who did not need to loose weight when they started the LCHF diet
If I needed to loose weight I would have no hesitation on doing low carb but if it meant loosing more weight then that worries me so I would like more information about that

 

[paul-1976]

Yes Andy I don't really know if I went LCHF if I would loose any more weight but there does not seem to be any statistics or information at all as to how LCHF affects people who do not need to loose weight I have read plenty on here from the low carbers who needed to loose weight but not read anything from a low carber who did not need to loose weight when they started the LCHF diet

There are some long term low carbers on here I know of who were skinny at diagnosis,perhaps they'll spot this and share some anecdotes with you.