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

peacetrain

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It's so heartening to read all your encouraging comments THANK YOU
Update; some of you will remember the research originally on 18 patients - well now there are 36 !! showing very similar results with average weight loss of just under 9.5 kg and very significant drop in HbA1c
A NEW ANGLE: What has got my interest now is the very surprising improvements in liver function which occur rapidly if on a low carb diet So much so from them I can predict who has lost weight and who hasn't before the person steps into the surgery. I wonder if too many folk link abnormal liver function with alcohol when carbs are to blame. I know I often made that mistake before I 'saw the light' Thoughts please
I was diagnosed T2 in November. Several years ago I had a blood test (can't remember what for now) and mention was made of the results showing some problem but nothing else said. I once asked my GP about it, when on a visit, and he said something about enzymes but nothing to worry about. He then asked me if I drank alcohol, which I don't. So I wonder if this was down to carbs. I asked for copies of tests last week so I'll have a look tomorrow to see what the exact information was.



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Totto

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I was diagnosed with a fatty liver in 2002 supposedly relating to alcohol consumption. Subsequent blood tests have confirmed that it wasn't getting worse but no test was carried out when I had my last HbA1c last month.

At my review I asked for the liver results as I wanted to make sure my LCHF diet wasn't affecting it. A further test revealed that my liver function had returned to normal.

So benefit of diet for me, in 9 months, has been reduced HbA1c from 65 to 35, blood pressure down from 140/82 to 119/65, weight loss of 3 and half stone, cholesterol, kidney and liver tests all returned to normal. In addition have stopped taking Glic and reduced Metformin from 4 to 1 per day


Type 2. Was out of control till I found this forum. Low Carb and testing saved me. Glucophage 1 per day down from 4. HBa1c down to 36
Exactly. LCHF is very dangerous. Or not.
 
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Lamont D

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I was also diagnosed with a fatty liver in 2001. The first question asked ' how much do I drink, when I replied I don' t the MD gave me a look that said she didn't believe me and suggested that I cut down, when I replied that because I have a low tolerance to alcohol(no doubt carbohydrate intolerant). She went on about a low fat diet with lots of healthy grains and greens ha!
Over the next couple of years, a new scan determined that my fatty liver and my function tests improved over a period of not because of her advice. I believe that the supposed 'healthy diet' that the doctrine of the NHS gives out has long term affects on the endocrine system!
 
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sunday1980

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Doh how have I only just found this thread ! :banghead:

I have had high ALT levels for last 2 years ranging from 160-80 which my doctor attributes to fatty liver, told me it was caused by alcohol, funny when I don't drink :rolleyes:
 

Totto

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I drink, wine anyway, now and then. I was diagnosed with diabetes in February, perfect cholesterol, had a liver scan due to tummy problems no fatty liver, perfect liver enzymes but I have been low carbing in a gentle way for years, as I knew diabetes would come eventually due to heavy genetic inheritance.
 

Indy51

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If you are interested in NASH and other liver conditions, you would probably find the blog of George Henderson of interest. He is a huge proponent of LCHF and restriction of Omega 6 PUFAs for all kinds of liver conditions:

http://hopefulgeranium.blogspot.com.au/

His post on Fatty Liver: http://hopefulgeranium.blogspot.com.au/2013/01/fatty-liver-and-its-treatment.html

His dietary recommendations for liver health: http://hopefulgeranium.blogspot.com.au/2012/10/my-dietary-recommendations-for-liver.html

He is working with the team at Auckland University (AUT) on their dietary guideline recommendations: https://scienceofhumanpotential.fil...lines-feedback-april-2014-revised-23-4-14.pdf
 
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gfmoore

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It's so heartening to read all your encouraging comments THANK YOU
Update; some of you will remember the research originally on 18 patients - well now there are 36 !! showing very similar results with average weight loss of just under 9.5 kg and very significant drop in HbA1c
A NEW ANGLE: What has got my interest now is the very surprising improvements in liver function which occur rapidly if on a low carb diet So much so from them I can predict who has lost weight and who hasn't before the person steps into the surgery. I wonder if too many folk link abnormal liver function with alcohol when carbs are to blame. I know I often made that mistake before I 'saw the light' Thoughts please

re your thoughts request.

Three months ago I was called in to my GP who told me I had high ALT results of 83. (40 is normal?). He asked about my drinking. As far as I was concerned I didn't drink too much. But perhaps I did drink a little too much - a can of high strength lager (8%) diluted with a can of stella (5%) perhaps four or five nights a week.

He told me to stop drinking. I didn't think I could, but I did. Had a bottle or two of Beck's Blue (0.001%) instead and many nights not at all. In the last three months I perhaps had beer (2 or 3 pints) on two occasions, one night half a bottle of red wine, and another time some diet coke and vodka. That was it.

My ALT yesterday was 90!!!! (My Gamma GT was 101)

So off for a liver scan next.

I have had no real info about this, how serious etc. Was just told that with no alcohol my liver would probably fix itself.

Oh I have been on lchf for just four weeks now. so maybe liver hasn't had time to adjust.

Could this be linked to my highish Dawn Phenomenon readings. Uhmmm.

Will keep you informed as to what the scan reveals.

Oh and well done on the article. the p-values were particularly impressive, no arguments there :)
 
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Southport GP

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There are a few, very short studies on low carb and fatty liver.
http://www.diabetesincontrol.com/in...ntent&view=article&id=10796&catid=1&Itemid=17

On the link with fructose http://nutrition.highwire.org/content/138/8/1452.full.pdf
http://christinecronau.com/wp-content/uploads/2011/10/nrgastro.2010.41.pdf

Dr Eenfeldt on the subject of fatty liver and LCHF http://www.dietdoctor.com/low-carb-diet-best-fatty-liver

I know I have seen a very short term indeed study, think it was only six days, where the liver fat was reduced at surprising speed but can´t find the link now, sorry.

I was reported for advocating the dangerous high fat diet to a member who had been diagnosed with fatty liver so I am relieved you mentioned this.

What about fatty liver and high triglycerides on low carb high fat?
Thanks those references were useful and new to me
 

Totto

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Thanks those references were useful and new to me
Happy to help. Do contact Dr Eenfeldt, he is a GP too, or was before the LCHF hype took off in a serious way. He is a nice bloke and would love to help you I am sure. And he knows a hell of a lot more about this than I do.
 

Southport GP

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If you are interested in NASH and other liver conditions, you would probably find the blog of George Henderson of interest. He is a huge proponent of LCHF and restriction of Omega 6 PUFAs for all kinds of liver conditions:

http://hopefulgeranium.blogspot.com.au/

His post on Fatty Liver: http://hopefulgeranium.blogspot.com.au/2013/01/fatty-liver-and-its-treatment.html

His dietary recommendations for liver health: http://hopefulgeranium.blogspot.com.au/2012/10/my-dietary-recommendations-for-liver.html

He is working with the team at Auckland University (AUT) on their dietary guideline recommendations: https://scienceofhumanpotential.fil...lines-feedback-april-2014-revised-23-4-14.pdf
The reduction in liver volume prior to bariatric surgery study v interesting Thanks Totto
 

donnellysdogs

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Southport - Do you have links to anything in the BMJ I can't quote to another GP? I don't have to be able to access it myself.

I'm pulling together material to write a paper for my GP, who is head of Practise, but freely admits diabetes isn't his thing. I'm keen to include as much peer information for him as I can, and I think the BMJ stuff will be important.

I have done well, reducing my scores to non-diabetic levels, without medication, and maintaining them for a few months thus far (although I am painfully aware this is the hard part). Sadly, the practise can claim no kudos in that, having recommended a low fat diet, "and avoid the sugary stuff, obviously", and decreed no need to self test. I want to make a case for revised dietary advice and support of testing from diagnosis, even if for a defined period, or self-funded. Not everyone is lucky enough to find this place, or to have a mind that challenges illogical logic. But, those people's health and well being is just as important as mine.

Many thanks, and well done, yet again, on all your hard work. I'm sure you've had your own torrid time with doubters and terminally resistant peers.


I am also Chair of our GP PPG and have passed your original stats etc on to our GP practice, however I would love to be able to pass on more information that you can give as well as "and breathe"


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sanguine

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re your thoughts request.

Three months ago I was called in to my GP who told me I had high ALT results of 83. (40 is normal?). He asked about my drinking. As far as I was concerned I didn't drink too much. But perhaps I did drink a little too much - a can of high strength lager (8%) diluted with a can of stella (5%) perhaps four or five nights a week.

He told me to stop drinking. I didn't think I could, but I did. Had a bottle or two of Beck's Blue (0.001%) instead and many nights not at all. In the last three months I perhaps had beer (2 or 3 pints) on two occasions, one night half a bottle of red wine, and another time some diet coke and vodka. That was it.

My ALT yesterday was 90!!!! (My Gamma GT was 101)

Interesting Gordon. When I had the tests in March that resulted in my T2 diagnosis my ALT was 51 and my Gamma GT 217 (!). Other liver tests were within normal range. No comment was made on these at all (it took time away from trying to prescribe statins). My drinking was a bit high although I called it sociable - around 3 bottles of red wine a week at dinner, sometimes with a G&T.

Since then I've cut right back to a glass of red with weekend dinners, and the occasional pint of bitter spread over a couple of hours if having a pub meal.

I need to ensure that the liver function tests are done again when I next have my HbA1c and lipids so I can see the change.
 

Southport GP

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Thanks everyone I am getting so interested in this liver thing which seems to have links with type 2 diabetes . I have now found lots of info on it under NAFLD (non alcoholic fatty liver disease). Prof Roy Taylor of Newcastle Uni knows much about it The only body organ that can deal with excess glucose is the liver - gradually the liver cells over burdened by glucose convert it to fat (triglyceride ) then the resulting fatty liver can cause insulin resistance which pre disposes to type two diabetes. There is a recognised link between a raised GGT or ALT liver result and the risk of diabetes. I am looking at the results and there are very significant improvements in these liver function tests in our LCHF folk who loose weight .
I wonder if this is a new way to help explain why a LCHF diet seems to help some folk ? I am in the process of writing it all up, sourcing references then will share more with you all .certainly showing more interest in liver function test seems worthwhile .
 
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Bluetit1802

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This is interesting. I have had a look at my own ALT and GGT results from my diabetes diagnosis tests. GGT was 18 and ALT was 24. These are both well within normal range. Does this mean I don't have a fatty liver, and if so, how come I have insulin resistance? Trying to understand .....
 

Southport GP

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This is interesting. I have had a look at my own ALT and GGT results from my diabetes diagnosis tests. GGT was 18 and ALT was 24. These are both well within normal range. Does this mean I don't have a fatty liver, and if so, how come I have insulin resistance? Trying to understand .....
 
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Southport GP

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Excellent point As I understand it about a third of type 2 diabetics don't have raised liver enzymes or fatty liver However conversely I suspect folk with a raised GGT not known to be diabetic should be screened for diabetes .At present the usual thoughts are alcohol or medication as likely culprits where I suspect for many too much glucose long term could be a cause ?
 
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Totto

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Thanks everyone I am getting so interested in this liver thing which seems to have links with type 2 diabetes . I have now found lots of info on it under NAFLD (non alcoholic fatty liver disease). Prof Roy Taylor of Newcastle Uni knows much about it The only body organ that can deal with excess glucose is the liver - gradually the liver cells over burdened by glucose convert it to fat (triglyceride ) then the resulting fatty liver can cause insulin resistance which pre disposes to type two diabetes. There is a recognised link between a raised GGT or ALT liver result and the risk of diabetes. I am looking at the results and there are very significant improvements in these liver function tests in our LCHF folk who loose weight .
I wonder if this is a new way to help explain why a LCHF diet seems to help some folk ? I am in the process of writing it all up, sourcing references then will share more with you all .certainly showing more interest in liver function test seems worthwhile .
Possibly there is a link to cholesterol too, at least triglycerides. I have been taught through a Swedish low carb forum that high triglyserides indicate metabolic syndrome, fatty liver, possible insulin resistance and the rest while us that really do LCHF and that is far higher in fat than any Atkins or such, usually have triglycerides on the low side of normal. I for example have tri at 0.7, LDL at 3.3 ( lowest ever) HDL at 2.2. And my GP wants me on statins, never I said. Personally I would have found my diabetes diagnosis easier if I had been taken seriously despite of my lack of metabolic syndrome but there you go, we are all different and you can have a wacky pancreas or at least beta cells without metabolic syndrome.

In short, I think you are on the right track. Fatty liver is a sign of the metabolic syndrome and is cured by LCHF as is the metabolic syndrome as such, diabetes or not.

Good luck, I think you are brave and do a really good job. Keep at it.
 
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gfmoore

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Though I haven't yet had the official results from my liver scan, the nurse? who did it said it was definitely a fatty liver, though there didn't seem to be any other issues in the liver she could see, She wasn't the most communicative of people, but I can understand that if she isn't a liver specialist I guess.

Though low carbing my weight loss so far is just a couple of pounds over six weeks. I guess I might be eating too much jelly, berries and cream. Typical compensation for the loss of choccy biscuits I guess.

Newcastle Dieting might be the answer I guess, but the thought of it for eight weeks seems a step too far for me. Maybe after my late summer holiday I'll think seriously about giving it a go.
 
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