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Discussion Direct Clinical Trial 2021 - 2022 Results

budhi76

Well-Known Member
Messages
53
Type of diabetes
Type 2
Treatment type
Other
Hi anyone know DIRECT program that put many diabetic into remissions?

What happen to the program as it doesn’t have any more updates in the website.
 
Hi @budhi76
I hadn't heard of the Direct study so I had a little search on Google to see what I could find
It seems to me that it's just the NHS trying to re invent the wheel.
The study has remarkable similarities to professor Roy Taylor Newcastle University study, starts with a very low calorie diet using meal replacement shakes. Then re introduce real food based on the infamous eat well plate.
ie - half your plate filled with fruit/vegetables, a quarter with bread/pasta/rice/potatoes and the other quarter with meat/fish/alternatives
I've copied their suggestions for a days meals when you come off the shakes

Breakfast: Bowl of high fibre cereal with
low fat milk and a banana
Lunch: 2 x slices of wholegrain bread with 2
slices of wafer thin ham , tomatoes and lettuce
Dinner: Whole wheat pasta with tomato sauce,
spicy chicken and salad

Fairly high carb with cereal, banana, bread, pasta, and low fat.
So starve the participants until they loose enough weight to improve, then give them the sort of diet that caused the problems in the first first place.
Then when they put the weight back on it will because they are greedy and couldn't keep to the diet. It couldn't possibly be that their eat well plate and diet advice is wrong, could it?
They are blaming Covid for delaying the publication of any results, but I'm sure when they do it will be proclaimed a resounding success.
 
Hi @budhi76
I hadn't heard of the Direct study so I had a little search on Google to see what I could find
It seems to me that it's just the NHS trying to re invent the wheel.
The study has remarkable similarities to professor Roy Taylor Newcastle University study, starts with a very low calorie diet using meal replacement shakes. Then re introduce real food based on the infamous eat well plate.
ie - half your plate filled with fruit/vegetables, a quarter with bread/pasta/rice/potatoes and the other quarter with meat/fish/alternatives
I've copied their suggestions for a days meals when you come off the shakes

Breakfast: Bowl of high fibre cereal with
low fat milk and a banana
Lunch: 2 x slices of wholegrain bread with 2
slices of wafer thin ham , tomatoes and lettuce
Dinner: Whole wheat pasta with tomato sauce,
spicy chicken and salad

Fairly high carb with cereal, banana, bread, pasta, and low fat.
So starve the participants until they loose enough weight to improve, then give them the sort of diet that caused the problems in the first first place.
Then when they put the weight back on it will because they are greedy and couldn't keep to the diet. It couldn't possibly be that their eat well plate and diet advice is wrong, could it?
They are blaming Covid for delaying the publication of any results, but I'm sure when they do it will be proclaimed a resounding success.

Thank you again catinahat for finding information and thorough research on the trial.

It kind of creating confusion after no follow up publication on the result.

As for the eat well plate, does it actually work based on the facts and experiences you have?
 
Porridge, no milk, just hot water, no sugar.
Baked potato with baked beans.
Meat with two veg with new poatoes.
For a decade, told by every doctor, dsn and one endo.
I was told, this would help losing weight, improve my health and prevent my T2 get worse.

After another referral I was told I wasn't T2. The porridge, spuds, beans and the wholemeal bread I had with it was literally putting so much weight on. I wasn't T2, and my health was so bad.
I am carb intolerant. As are a lot of diabetics.

I don't understand the logic, if you are carb intolerant, creating higher blood glucose levels, with every meal, is not going to do anything but make you worse!
 
Porridge, no milk, just hot water, no sugar.
Baked potato with baked beans.
Meat with two veg with new poatoes.
For a decade, told by every doctor, dsn and one endo.
I was told, this would help losing weight, improve my health and prevent my T2 get worse.

After another referral I was told I wasn't T2. The porridge, spuds, beans and the wholemeal bread I had with it was literally putting so much weight on. I wasn't T2, and my health was so bad.
I am carb intolerant. As are a lot of diabetics.

I don't understand the logic, if you are carb intolerant, creating higher blood glucose levels, with every meal, is not going to do anything but make you worse!
Yes. If you look at the medications available to treat diabetes, such as insulin, sulfonyls, Actos, GLP-1 argonists and others, they all work by increasing insulin levels either directly or by squeezing the life out of the pancreas. What does insulin do? It allows us ro use the glucose in our muscles (provided we are not insulin resistant) which is fine if we are super athletes and doing HIIT to burn it as energy.. OR we use the insulin to force any excess glucose into the adipose tissue as storage of fat normally around the midriff. So T2D tend to put on weight around the tummy but may well be keeping sugar levels in control according to the meter. The dilemma is how to reduce both aspects at once. I found Low Carb to be very effective in this solution as do many others here. It is a way of controlling both weight and blood sugar and needs no prescriptions. But it does not replace insulin for those who find they need it, but then there are ways and means to improve control which are not available to a T2D on orals or lifestyle. In the days before insulin was discovered, Low Carb was indeed a remedy in use for treating diabetes but in those days most diabetics were T1D so it was not very successful, which may be why the medical profession is so against LC diets.

The Low Cal or ultra low calorie diets such as Newcastle are the modern Boot Camp equivalent. They provide a short(ish) sharp (starvation) shock to reset the system, but then it is up to you as to what you do afterwards which is where the pitfalls lie. If you alter your lifestyle (i.e. perhaps with low carb) then the miracle results can be prolonged and all is hunky dory, But if you use it to allow you to go back to the former eating habits, they will bite you in the backside again. The ND approach is not guaranteed to give immunity through 'remission'. It is not a cure (IMHO).
 
The dietitian I had one appointment with after my diagnosis tried to force the Eatwell plate on me. I politely turned down a second appointment and stuck with low carb.
The starvation level quick shock diets may mean you lose weight, for a while, but most will put it back on using the Eatwell plate levels of carbs.
It can never replace a low carb diet.
 
Yes. If you look at the medications available to treat diabetes, such as insulin, sulfonyls, Actos, GLP-1 argonists and others, they all work by increasing insulin levels either directly or by squeezing the life out of the pancreas. What does insulin do? It allows us ro use the glucose in our muscles (provided we are not insulin resistant) which is fine if we are super athletes and doing HIIT to burn it as energy.. OR we use the insulin to force any excess glucose into the adipose tissue as storage of fat normally around the midriff. So T2D tend to put on weight around the tummy but may well be keeping sugar levels in control according to the meter. The dilemma is how to reduce both aspects at once. I found Low Carb to be very effective in this solution as do many others here. It is a way of controlling both weight and blood sugar and needs no prescriptions. But it does not replace insulin for those who find they need it, but then there are ways and means to improve control which are not available to a T2D on orals or lifestyle. In the days before insulin was discovered, Low Carb was indeed a remedy in use for treating diabetes but in those days most diabetics were T1D so it was not very successful, which may be why the medical profession is so against LC diets.

The Low Cal or ultra low calorie diets such as Newcastle are the modern Boot Camp equivalent. They provide a short(ish) sharp (starvation) shock to reset the system, but then it is up to you as to what you do afterwards which is where the pitfalls lie. If you alter your lifestyle (i.e. perhaps with low carb) then the miracle results can be prolonged and all is hunky dory, But if you use it to allow you to go back to the former eating habits, they will bite you in the backside again. The ND approach is not guaranteed to give immunity through 'remission'. It is not a cure (IMHO).
Yeah, but the many variables and causation of T2, does not fit the illogical one size fits all solution of the eat well plate, meds or insulin.
Many T2s have a cause and effect of high circulating insulin, insulin resistance and first phase insulin response, never mind the unlucky ones who have hyperinsulinimia.
Because insulin tests are rarely used. How do they know that the doctors are causing more harm, as in my case?
There should be more tests before insulin is introduced for T2s!

Having too much insulin is bad. That is my reason for being in keto. I overproduce insulin, I don't use insulin properly, hypoglycaemia is not recommended.
 
Yeah, but the many variables and causation of T2, does not fit the illogical one size fits all solution of the eat well plate, meds or insulin.
Many T2s have a cause and effect of high circulating insulin, insulin resistance and first phase insulin response, never mind the unlucky ones who have hyperinsulinimia.
Because insulin tests are rarely used. How do they know that the doctors are causing more harm, as in my case?
There should be more tests before insulin is introduced for T2s!

Having too much insulin is bad. That is my reason for being in keto. I overproduce insulin, I don't use insulin properly, hypoglycaemia is not recommended.
I totally agree. In times previous they used the OGTT tests for T2D but they used to do c-peptide concurrently so could determine IR, and insulin production level. but the modern stripped down OGTT does not measure insulin, and is only really used for gestational diabetes investigations. So the majority of patients who are DX'ed T2D haven't got a clue as to whether they are IR or ID or as you say hyperinsulinemic. Worse still, many T2D find they should have been classed T1D or LADA or MODY instead.
 
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For me no... I ate as suggested by the Eatwell Guide for years and just got fatter and sicker.

Cut out carbs almost entirely, lost a lot of weight and put T2 into remission.

I see, thank you for sharing your experience. Kust wonder do you mean cut out carbs, including low carbs fruit like blueberries?
 
I see, thank you for sharing your experience. Kust wonder do you mean cut out carbs, including low carbs fruit like blueberries?
Blueberries are one of the higher carb berries.. I eat raspberries and strawberries for fruit as a "treat" and that's about it.
That aside my eating is mainly meat based with some fish and dairy and sometimes veg but not always.
 
While I am all for saying when it's wrong..

My recent visit with DN was a revelation.

They listened to me, discussed ideas like I was an adult, sentient being.. marvelous stuff

While not perfect, it is good to see movement towards a better outcome for T2D's.

Mine offered me the
REWIND Programme.


As an aside, I mentioned this forum & how informative it was
I even mentioned how well I had done before accident (58 down to 40 in around 4 months )

They agreed it was a great result
I Asked how many others did so well..mmhh

The said they see around 10-12 people a week x 52 weeks...520 very rough estimates...4 years since DX = circa 2000 patients.

How many similar to me improvement wise......4.:wideyed:

or 16 if they meant it's 4 a year ...not even 1%.

Yet no one seemed interested enough to asked me how I did it. :banghead::banghead::banghead:


Still a way to go yet .
All we can do is keep on pushing on .
 
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I totally agree. In times previous they used the OGTT tests for T2D but they used to do c-peptide concurrently so could determine IR, and insulin production level. but the modern stripped down OGTT does not measure insulin, and is only really used for gestational diabetes investigations. So the majority of patients who are DX'ed T2D haven't got a clue as to whether they are IR or ID or as you say hyperinulinimic. Worse still, many T2D find they should have been classed T1D or LADA or MODY instead.
or food allergies, intolerances, hypoglycaemia.
When you read some posts and there is sometimes, those who have posted similarities in symptoms and having high and low readings. Without knowing the whole story, the majority of doctors just don't have the information or tests available to diagnose the differences in the diabetic/endocrine umbrella.

For example, if a patient, went to a GP and was having symptoms of Hypoglycaemia, the finger prick test done by GP was low. The patient then had a hba1c test and found to be high in diabetes levels because of breakfast the patient had. The patient complained that they were going hypo overnight, then high because of work related issues, snacking. The patient was losing weight, the patient was going low when fasting. The patient complained of the usual suspects when hyperglycaemia was present.

This is not T2, T1, or any other we have mentioned.

This is a pancreas that is over producing for some reason, possibly insulinoma or pancreatitis or pancreatic cancer, maybe something else that triggers insulin levels over and above normal hormonal response.
It could be a form of hyperinsulinimia. Or hypoglycaemia, there are many forms.

The tests the GP's use are and should only be a first step to diagnosis.
The numbers that come on the internet looking for help with the symptoms and quick negligent hba1c diagnoses. Is unrealistic to modern knowledge.
 
I was searching for something and your post came up. I misread Direct Trial for Predict and wondered how come you had those results before me!

(It's OK. I'm back in my box now. :joyful: )
Liking the humour...lol.

It's all about sharing & discussing info.

With such a wealth of data, it can be hard to post something that hasn't been mentioned elsewhere on here, and not be aware.

As for misreading...haha..welcome to the club .

End of the day it's about informing AND being informed, that helps ALL of us make the best, most well informed choice for our own personal circumstances.

And this forum & it's members certainly provides that in abundance.

Long may it continue to do so. :cool:
 
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