Doing the Newcastle

I've just moved this from a blog to the forum - thinking it might be useful for supporting others and getting support for my efforts too.

It's now 10th December and I'm starting the Newcastle diet tomorrow - this afternoon we have a Christmas meal and I don't want to miss it. I'm writing this as a way of monitoring progress and to reinforce commitment. I live in rural Spain and my current GP is not supportive. I follow a low carb diet but my levels have been rising in the last six months despite being put on insulin last Summer. He is reluctant to offer additional medication and suggests I eat more fruit. Other GPs have the same view, lacking modern training, and there is little or no access to specialists except privately. So for me, he is at best a neutral contributor to my treatment and I need to address my condition more radically. The Newcastle Diet seems to offer some hope.

I was diagnosed T2 in 2004, when I was fifty, and for several years I was on metformin. It kept me around 7.0 - 7.5 and my GP at the time was satisfied with that. Having moved to Spain in 2008 it was clear that GPs here still regard diabetes as the inevitable result of obesity and that the answer is to eat less and exercise more. Despite being on a diet of around 1300-1500 calories I am still overweight, currently at 106kg. My weight increased 10kg within three months of starting insulin and has stayed at that level for the last two months. Around five years ago, I consulted a specialist privately because I could not persuade the GP to change the medication and my numbers were rising. The specialist recommended Icandra (a combination of vildagliptin and metformin) which the GP accepted and then promptly halved the recommended dose - only corrected when I brought my numbers back to him and complained. My dose of insulin (Toujeo) has now been steadily increased from an ineffective 10 units to 56 units. To say it has been difficult getting effective treatment is an understatement but it would be wrong to blame the GPs here. There have been savage cuts for almost a decade and their in-service training is almost non-existent. They are under severe budget pressure to restrict medication and referrals. I wouldn't want their job for anything.

So... my options are quite restricted. I can plod along and accept the more frequent neuropathy pain and watch the numbers creep up and increase the insulin, or I can try to do something about it.

I have a background in biochemistry and I have studied the research (including the excellent material from Ivor Cummings in Ireland) that I can get hold of though many publishers keep the research behind paywalls. Roy Taylor's theories provide a powerful explanation of everything that I've observed in myself and offer some hope. I hope that although I was diagnosed over thirteen years ago, I'll still have some recoverable beta-cell functionality but in any case, the drop in weight and recovery of liver function is certainly worth the eight weeks of struggle.

I've been able to get hold of the shakes, SlimFast, here in Spain though it's clearly a highly profitable product line... I intend to post my weight and FBG each day with any comment I think might further motivate me or help anyone else reading it. Even if no-one reads it, it'll be useful for me.

Numbers:
FBG this morning 5.3 (unusual - it's typically 6.5+)
Weight: 106kg
Last HbA1c 9.4

And we're off...


Day 1 11th Dec FBG: 7.7 Weight: 104.8 kg
And a big surprise. After a half-hour hilly walk late afternoon which I often take, my blood was at 4.1. I haven't seen that level in years with the one exception of a hypo. I hope it's a sign of more to come.

Day 2 12th Dec FBG: 5.6 Weight: 104.8kg
Woke up feeling tired and I have a cold and cough, neither of which is going to change anything. Feeling quite positive and glad I've actually started. Keeping strictly to the 800 limit. Am I skeptical? Maybe a little (I've tried and stuck to other diets) but definitely hopeful too.

Saw the doc this afternoon and told him what I was doing. His advice? Diets are good but need to be 1500 calories of which between 40 and 50% should be carbohydrate. Eat plenty of fruit... He is decades out of touch with the research and the data but no matter. He did say "buena suerte" (good luck). I hope to have some good news for him in due course.

Bluetit1802 said:

Well done on taking the bull by the horns and trying to help yourself when all your doctors have failed. I wish you luck.

However ....... what are you doing about your insulin? I am worried you may start to hypo if you cut right down on carbs.

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Yeah, I've thought a lot about that and I agree that it's really important. I immediately cut out a meal-time combination pill of vildglyptin/metformin and I'm monitoring my blood four or five times a day so as soon as there's a noticeable drop in FBG which is sustained during the day I'll cut the insulin. I'm on Toujeo which is long acting so I'll start to drop it fairly soon. I'm monitoring carefully the response to food at 1, 2 hours so I hope I'll get enough data to be sensible about it. I'm retired and at home so I won't be caught up a ladder

Thanks for the advice.

Day 3 Wednesday 13th December. FBG 6.7. Weight 104.2kg.

I'm still taking the long-acting insulin and I'll do so until I see a consistent drop in FBG. then I'll tail it off. The liver's recovered insulin sensitivity will be impaired if I'm still swimming in insulin. Good that the weight's coming down. I now have a flu-like cold, hacking cough, shivering though I can hardly attribute that to the diet. Just a nuisance and bad luck but it won't affect what I'm doing. I'll keep myself wrapped up and warm with some paracetamol and ibuprofen. We can get 600mg tablets here in Spain over the counter.

Guzzler said:

Wednesday 17th?

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Edited. Ta.

Freema said:

Wow hope you’ll have a fine journey .... I am watching from the sideline an hope you go the whole ride of 8-9 weeks

I Think you should be careful already with you insulin it is very dangerous to get too low

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Yes, I'm monitoring the levels very carefully. At present, they haven't come down and there's no time during the day when I'm at risk of a hypo. I check last thing at night as well to prevent a hypo during the night. It's very good advice to keep on top of this and monitor it closely. Thanks.

Day 4 Thursday 14th December. FBG 6.8 Weight 102.2kg.

Pleased and a little surprised at the weight loss. Mostly water I'm sure but good to see nonetheless. The blood sugar still hasn't dropped much but in anticipation I've reduced the insulin a little to see the effect during the day. If all goes well, I'll keep reducing it. I have a hacking cough so that will have raised the blood sugar a little. Of course, the right way to do all this would be to have an insulin assay from a laboratory that tells me exactly the amount of insulin in the blood and then we could calculate pretty closely what would match the intake but even that wouldn't be totally precise and I don't actually have a lab in my pocket So it's play it by intelligent ear. The shakes are surprisingly filling and I no longer feel hungry after an uncomfortable first couple of days. I was forewarned by other people's accounts so that helped with expectations. Pleased that my weight will be in double figures fairly soon - long time since that happened. So mostly positive.

Tabbyjoolz said:

@AlcalaBob - Good luck and keep us posted!

I'm starting ND next month, so any tips would be much appreciated.

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I an old lag with T2 being diagnosed back in 2004 and I've struggled with control for a long time. This is the first time I've felt really hopeful that research is getting at the problem and finding a solution. So I'm very committed. I'm a complete newbie with the Newcastle but I can see that psychological preparation is important, so here are my probably naïve suggestions:

1 Have a goal that promotes success, not just one that looks easy to achieve. For weight loss, go for 15% of body weight or 15kg, whichever is the greater and set that as the serious target. We have to recognise it's not a walk in the park, it's a serious challenge. If we want the result, we need to hit a serious target.

2 Enlist the support of partners, family. I know I will be miserable at times and I don't want that to derail me. They know that and will help me stay focused. They will have a sense of humour at just the time when I won't. Invaluable.

3 Record everything, even if it seems trivial. What you've eaten, when, how you felt, obvious things like BG and weight but also level of energy, activity, positivity. It's useful to look back on it. I've already found it useful just after a few days.

4 Be clear with yourself that certain edible things are simply not available to you because they are not on the diet plan. So don't even consider them as food. If you can physically remove them so much the better. I just prepare my food when no-one else is in the kitchen - I had to keep away from the wonderful smell of minced pies being cooked... Silly, but why risk it?

5 Plan meals and times - it's not going to be difficult because it's probably... a shake...

6 Don't obsess if a reading is poor. Weight might fluctuate, blood levels certainly do. Stick to the plan. Think 'trend' and wait for enough numbers before making a judgement.

This might all be hopelessly naïve and I might well retract this in a few weeks' time but for now, it seems to be working for me. All the best, and good luck.

ringi said:

You can not calculate the inslin you need as you will lose liver fat within one or two weeks of starting the ND, and as the liver fat is lost your insilin reistance will greatly reduce. Hence in the recent study they stopped most meds on day one, and only restarted them if people had a BG above 20 after two weeks. (I don't know if they allowed anyone on insulin.)

Personly I think a FBG 6.8 is too low while doing the ND with insulin and you should be aiming more towards 10 for the first few weeks. Once the fat is removed from your liver, your insilin reistance is unlickly to change quickly.

(I also think the 8 week blood suger diet is better then the shakes as it is much lower carbs, and hence easyer to get insulin doses right. Maybe make the shakes up with water rather then milk to reduce the carbs.)

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Yes, I totally agree with the science. Any insulin assay is simply a snapshot and it might be of use in a steady state environment in which BG is balanced by an insulin dose. The ND is all about disrupting that balance by recalibrating the liver and pancreas. I appreciate the reasons Taylor et al stopped all medication because in a clinical trial it was one of the variables that could have invalidated their conclusions. It was essential for them to stop all medication. But given their results, it's no longer essential for us as long as we monitor it carefully. For us now it's a matter of safety rather than validity of Taylor's results. Once the liver starts to increase its insulin sensitivity, I anticipate a drop in BG and particularly a good response to a load such as a shake. That's not happening for me just yet so I have to monitor it continuously and closely. I have already started to tail off the insulin dose and will do so every couple of days. There's nothing in the trial papers or documents that indicate a target level for FBG in the first few weeks and without medication it's not something you can actually aim at, though clearly a level of 20 indicates that the liver has not yet recovered sufficiently to cope. Thanks very much for your advice. It's much appreciated. There are always more things to take into account and I'm grateful people take the trouble to consider it and respond.

http://www.ncl.ac.uk/media/wwwnclac...centre/files/2017 Information for doctors.pdf

This advice to GPs from Professor Roy Taylor suggests reducing insulin rather than totally stopping it but also that medical support should be sought if BG becomes 'very high', ie FBG over 10mmol/L, or alternatively very low, presumably 4 or less. It suggests that insulin can be withdrawn after a fortnight given a good response and that's what I'm hoping for in my case.

Thank you for you comment. Had you not raised this, I wouldn't have looked it up again and checked it. Many thanks.

ringi said:

A bit of history will help understand this, there is a diet company called “LighterLife” that uses shakes very much like the ND along with group cognitive behaviour therapy. This has been operating for a long time (before ND started) with a business model like “weight watchers”. They require everyone to get a letter of approval from their doctor before doing it due to risks of Hypos etc, if they are taking any drugs.

Now to quote from my GP’s website:

Will a Doctor sign my "Lighterlife" form upon commencement of this Programme?

Unfortunately we are not able to commit to the degree of monitoring that is required by this Programme, after consideration of the National Institute For Clinical Excellence guidance we have concerns about being able to sign these form so sorry, no.​

This is due to doctors having change people meds a daily bases to keep BG in the NICE defined target range.

The recent ND study was looking at how well the ND works in a GP setting, hence they needed to remove all objection GPs could have over the workload it created. By just excepting higher BG, all the needed support could be provided by a nurse at a once weakly appointment.

(Likewise possible GI issue with having Metformin with the shakes leading to GP apointments. Personly if it is possible I think Metformin should be kept going taken with the once a day "veg meal".)

One issue with LighterLife is a lot of people stop paying for the meatings once they have completed the shakes stage, and hence don't get the surport needed to reintroduce food in a controled method. This process was well defined with the recent ND study.

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Interesting. The validity of the conclusions was the reason Taylor gave for stopping medication but clearly there are other considerations in a GP setting. In my case I have to do this without medical support because it's just not there. In one way, I don't mind since it has to be my responsibility to reach and maintain the target weight. I'll carefully follow the guidelines provided by Taylor and see how it goes. I'm just in the process now of translating some of the materials into Spanish and I might just pass it on to my GP... after I've achieved the desired results. He's not receptive at the moment but if I present with normal results, I think he'll be more open to a new approach.