Neohdiver
Well-Known Member
It is the first Newcastle study - but I got the duration wrong (it was up to 4 years post-diagnosis, not 1).
Both Newcastle studies collected substantially more data than A1c - the first more thorough than the second. In the first, addition to the markers that merely indicate good control (A1c and BG), the participants were measured for: fasting insulin secretion, arginine induced insulin secretion (first phase), and pancreatic and liver fat content - and were followed up 12 weeks later with an OGTT. (At 12 weeks after the end of the study, 3 of the participants had a recurrence of diabetes. No case-by-case information about whether diabetes recurring was associated with returning to prior (full-calorie) eating habits.)
You are correct about the remission rate in the second study (with patients with longer duration of disease and, if I recall correctly, far less dense data collection) - that reversal rate was less than 50%, and generally split along the lines of duration of disease and age. Younger participants, with shorter disease duration achieved remission; older participants with longer disease remission didn't. I got one of the two going for me!
Remission in the second study was determined based on the "gold standare" inslin secretion test (not A1c or even by the more reliable OGTT). Responders returned to a normal insulin secretory response (and remained there for the 6-month follow-up); non-responders did not. They also collected longer post-intervention data - which showed that reversal in those who achieved it was sustained with weight maintenance on a diet that was not intentionally carb-restricted.
It was actually the rigor of the Newcastle studies, the care with which they distinguished between control (e.g. A1c, finger pricks) and remission (e.g. insulin secretion response - particularly 1st phase, change in fat composition of pancreas {previously linked to expression of diabetes} and the OGTT) that convinced me that it was worth a try. The studies are way too small to give any indication how many people can achieve remission, or what characteristics - other than the blunt duration and age seem to matter. But what they did prove, becuase they used criteria associated with a normal glucose metabolism, v. mimicking a normal response by tight control (and becuase after 6 months of eating a diet restricted by calories but not by carbohydrates, at least on one of those criteria the glucose metabolism was still normal), that prove to me it is possible for some people. Since the risks of trying are extremely low, it is worth it to me to try. (In contrast - I would not make the same decision, based on the same data, to try a drug unless the side effects were already well-known and very minimal. My decision to try any new medical approach is always based on there being some well-controlled and documented success + minimal to no risk to the new approach + no requirement that I forfeit a known beneficial approach in order to try it.).
I do think Taylor has now gone off the rails. His first study (and all subsequent studies) have been based on a 600-800 calorie diet, on the premise that, "Little attention has been paid to the potential role of a sudden negative energy balance on glucose metabolism after bariatric surgery," so he set out to study that role. He now touts a personal fat threshold, based on nothing beyond volunteered anecdotes & theorizing. That, to me, sounds like the same-old, same-old mostly failed theory that if you lose 10% (or 15%, etc.) of your body weight you can reverse diabetes. Just don't name a specific amount, so you can't be blamed when they fail. (My mother lost more than 15%; I have lost 35% of mine. No dent in either of our glucose metabolisms (the improvement in mine came in connectiton with the BSD). My grandfather - from whom we (and everyone else my age or older who descended from him inherited it) didn't have 10% to spare when he was diagnosed.)
Both Newcastle studies collected substantially more data than A1c - the first more thorough than the second. In the first, addition to the markers that merely indicate good control (A1c and BG), the participants were measured for: fasting insulin secretion, arginine induced insulin secretion (first phase), and pancreatic and liver fat content - and were followed up 12 weeks later with an OGTT. (At 12 weeks after the end of the study, 3 of the participants had a recurrence of diabetes. No case-by-case information about whether diabetes recurring was associated with returning to prior (full-calorie) eating habits.)
You are correct about the remission rate in the second study (with patients with longer duration of disease and, if I recall correctly, far less dense data collection) - that reversal rate was less than 50%, and generally split along the lines of duration of disease and age. Younger participants, with shorter disease duration achieved remission; older participants with longer disease remission didn't. I got one of the two going for me!
Remission in the second study was determined based on the "gold standare" inslin secretion test (not A1c or even by the more reliable OGTT). Responders returned to a normal insulin secretory response (and remained there for the 6-month follow-up); non-responders did not. They also collected longer post-intervention data - which showed that reversal in those who achieved it was sustained with weight maintenance on a diet that was not intentionally carb-restricted.
It was actually the rigor of the Newcastle studies, the care with which they distinguished between control (e.g. A1c, finger pricks) and remission (e.g. insulin secretion response - particularly 1st phase, change in fat composition of pancreas {previously linked to expression of diabetes} and the OGTT) that convinced me that it was worth a try. The studies are way too small to give any indication how many people can achieve remission, or what characteristics - other than the blunt duration and age seem to matter. But what they did prove, becuase they used criteria associated with a normal glucose metabolism, v. mimicking a normal response by tight control (and becuase after 6 months of eating a diet restricted by calories but not by carbohydrates, at least on one of those criteria the glucose metabolism was still normal), that prove to me it is possible for some people. Since the risks of trying are extremely low, it is worth it to me to try. (In contrast - I would not make the same decision, based on the same data, to try a drug unless the side effects were already well-known and very minimal. My decision to try any new medical approach is always based on there being some well-controlled and documented success + minimal to no risk to the new approach + no requirement that I forfeit a known beneficial approach in order to try it.).
I do think Taylor has now gone off the rails. His first study (and all subsequent studies) have been based on a 600-800 calorie diet, on the premise that, "Little attention has been paid to the potential role of a sudden negative energy balance on glucose metabolism after bariatric surgery," so he set out to study that role. He now touts a personal fat threshold, based on nothing beyond volunteered anecdotes & theorizing. That, to me, sounds like the same-old, same-old mostly failed theory that if you lose 10% (or 15%, etc.) of your body weight you can reverse diabetes. Just don't name a specific amount, so you can't be blamed when they fail. (My mother lost more than 15%; I have lost 35% of mine. No dent in either of our glucose metabolisms (the improvement in mine came in connectiton with the BSD). My grandfather - from whom we (and everyone else my age or older who descended from him inherited it) didn't have 10% to spare when he was diagnosed.)
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