Dr Jason Fung on T2 Diabetes and Drugs

[Robkww]

If you need drugs take the best option, if you don't need drugs why take them - who really knows either way what the longer term implications will be? This forum is great but can become a bit navel at times.

 

[Mbaker]

But if you maintain healthy blood levels why take them ? I've recent seen my hda1c come down to 59 from 102 in 8weeks. I have stopped my Metformin and seen my bg level drop again.

Should I consider my self lucky that I have been prescribed metformin ?

I think the protocol should be drug free first. I dropped for over 20 mmol to 16 in 1 whilst not knowing what I was doing (still eating home made bread and home made banana cake etc, what if I had known what I was doing). I was still put on Metformin, when a 20% drop on the wrong food for me shows I could have continued this, this was followed by another year of extreme exercise (which worked), but I could have had an easier time. Once my wife looked at the science things have been great.

 

[CherryAA]

In an ideal world, everyone would get proper instruction about carbs, told when to test to keep records and come back in a month. Many people would realise then they can achieve their goals without drugs or much medical intervention freeing up the health service to deal with the cases where thy do not respond to the regime for whatever reason.

 

[Oldvatr]

But if you maintain healthy blood levels why take them ? I've recent seen my hda1c come down to 59 from 102 in 8weeks. I have stopped my Metformin and seen my bg level drop again.

Should I consider my self lucky that I have been prescribed metformin ?

Yes. As pointed out, Metformin reduces the overall mortality risk for someone with diabetes, BEYOND pure bgl control.

In fact Metformin does very little towards dropping bgl levels, but does act to protect the heart and other vital organs by reducing insulin resistance.

Our condition needs more than just reducing the HbA1c to a magic number, You should look on the holistic approach for best protection.

 

[dbr10]

This is why I was so disappointed to be refused a C-Peptide test by both GP and diabetic specialist who did however order a Gad test.

My doctor ordered C-Pepride test. Lab ignored it

 

[Oldvatr]

I think the protocol should be drug free first. I dropped for over 20 mmol to 16 in 1 whilst not knowing what I was doing (still eating home made bread and home made banana cake etc, what if I had known what I was doing). I was still put on Metformin, when a 20% drop on the wrong food for me shows I could have continued this, this was followed by another year of extreme exercise (which worked), but I could have had an easier time. Once my wife looked at the science things have been great.

If you actually read the protocol, then it is clear that for newbies presenting with relatively low bgl readings, then the protocol starts with diet adjustment , and meds are only prescribed when the bgl rises above a threshold. So your 20 (or 16) mmol/l certainly puts you firmly in the second category. If the protocol recommended a diet was one that actually works to reduce bgl, then your commentary could be valid, but as things stand today the Eatwell diet has the opposite effect, and it is this part of the protocol that needs to change.

Had I found this website10 years ago it would have made not a jot of difference to my life, since it is only in the last 3 years that the science has begun to catch up with the low carb / fasting protocols that actually work.

We on this Forum are in fact very priviledged to gain access to the science and advice that supports this revolution. If you were to be on the other (DUK) diabetes forum, then you will still be getting the OLD advice, and would probably still be following an HCLF diet and being told not to self monitor. (actually the other site would have lead you down the same path you describe, except that you would probably still be having a higher HbA1c, since that website does not support low carb diets or fasting even today)

 

[Oldvatr]

My doctor ordered C-Pepride test. Lab ignored it

This topic was discussed at length in the following thread
http://www.diabetes.co.uk/forum/threads/c-peptide-gad-test-on-nhs.120490/

I live in an area that does not have the facilities to do this test,

 

[Daibell]

This is why I was so disappointed to be refused a C-Peptide test by both GP and diabetic specialist who did however order a Gad test.

Although it's nice to know if you have GAD antibodies as that proves T1 I think for the others like me who show up as GAD negative the c-peptide helps with the correct treatment regardless of cause as GAD is not the only cause of beta cell death.

 

[Daibell]

If you actually read the protocol, then it is clear that for newbies presenting with relatively low bgl readings, then the protocol starts with diet adjustment , and meds are only prescribed when the bgl rises above a threshold. So your 20 (or 16) mmol/l certainly puts you firmly in the second category. If the protocol recommended a diet was one that actually works to reduce bgl, then your commentary could be valid, but as things stand today the Eatwell diet has the opposite effect, and it is this part of the protocol that needs to change.

Had I found this website10 years ago it would have made not a jot of difference to my life, since it is only in the last 3 years that the science has begun to catch up with the low carb / fasting protocols that actually work.

We on this Forum are in fact very priviledged to gain access to the science and advice that supports this revolution. If you were to be on the other (DUK) diabetes forum, then you will still be getting the OLD advice, and would probably still be following an HCLF diet and being told not to self monitor. (actually the other site would have lead you down the same path you describe, except that you would probably still be having a higher HbA1c, since that website does not support low carb diets or fasting even today)

The good news is that the other forum site is getting much better with diet advice etc which I think reflects the fact that DUK is (very) quietly realising that the old advice to stuff yourself with carbs is seriously bad.

 

[Oldvatr]

The good news is that the other forum site is getting much better with diet advice etc which I think reflects the fact that DUK is (very) quietly realising that the old advice to stuff yourself with carbs is seriously bad.

Agree, but having posted myself on the site about LC diets, there is quite severe resistance among the the forum readers, so DUK have an uphill struggle to educate their readership as well as protect their sponsors interests. They are missing the science discussions that underpin the new diets, having personally been modded out off the site on occasion for .trying to put up relevant links to "unsafe site or source" such as Wiley or Joslin

The LC diet they have recently published on the website proper is actually medium carb (100 g/meal) and carried a very strong anti LC warning message that took up more newsprint than the recipe itself.

 

[dbr10]

This topic was discussed at length in the following thread
http://www.diabetes.co.uk/forum/threads/c-peptide-gad-test-on-nhs.120490/

I live in an area that does not have the facilities to do this test,

They do, but they knew better than the doctor

 

[ringi]

Metformin is a treatment for insulin resistance not high BG, insulin resistance is a large risk factor for.

• Type 2 Diabetes
• Strokes
• Hart problems
• Memory Problems
• Foot problems
• Weight gain
• Fatty liver
• Etc

As the NHS does not do a blood test for insulin resistance, we can’t say someone would not benefit from Metformin based on a standard set of blood test.

(Metformin does drop BG more than it is given credit for, but takes a long time to do so, and only does so if someone has a high level of insulin resistance.)

 

[ringi]

I would say that Doctors have a duty to warn of the potential side effects of Metformin, particularly the potential for Kidney damage.

Should the doctor warn you of the risk of getting killed in a car accident while going it to have a set of blood tests done? Where do you want the line to be drawn?

Is it not our duty to read the information leaflet that comes with all meds to find out about these small risks?

 

[JohnEGreen]

Some patients may be illiterate and unable to read or dare I say it dyslexic and also unable to read the leaflet.

The doctor is responsible for what he or she prescribes not for how his patient travels to or from the surgery.

Some risks are not so small as to be dicounted all together.

 

[ringi]

Legally it the chemist responsibly to check that someone knows the risks etc of a prescription not the doctors and there is nothing stopping someone who can't read the leaflet from asking the chemist.

 

[Mbaker]

Should the doctor warn you of the risk of getting killed in a car accident while going it to have a set of blood tests done? Where do you want the line to be drawn?

Is it not our duty to read the information leaflet that comes with all meds to find out about these small risks?

Not the same thing, and a distant analogy, at a time when you are most vulnerable and ignorant, and in the context in my case of having a 20% reduction in blood glucose readings after just 1 week, I would expect my HCP to give me the facts. One of my friends earlier this year was diagnosed with a brain tumour, was not warned about potential Type 2 when steroids were given...now has Type 2, I seat next to a chap at my networking group, again a tumour, given steroids, you can guess what he got next. I'm afraid after all these experiences I cannot be persuaded that the onus is on the non professional.

 

[Mbaker]

If you actually read the protocol, then it is clear that for newbies presenting with relatively low bgl readings, then the protocol starts with diet adjustment , and meds are only prescribed when the bgl rises above a threshold. So your 20 (or 16) mmol/l certainly puts you firmly in the second category. If the protocol recommended a diet was one that actually works to reduce bgl, then your commentary could be valid, but as things stand today the Eatwell diet has the opposite effect, and it is this part of the protocol that needs to change.

Had I found this website10 years ago it would have made not a jot of difference to my life, since it is only in the last 3 years that the science has begun to catch up with the low carb / fasting protocols that actually work.

We on this Forum are in fact very priviledged to gain access to the science and advice that supports this revolution. If you were to be on the other (DUK) diabetes forum, then you will still be getting the OLD advice, and would probably still be following an HCLF diet and being told not to self monitor. (actually the other site would have lead you down the same path you describe, except that you would probably still be having a higher HbA1c, since that website does not support low carb diets or fasting even today)

When you consider I was told to come back in a week, did so and obtained a 20% reduction I think it is a valid position in hindsight to suggest that diet be the first port of call. A 20% reduction is statistically important and should have indicated that my condition was dietary - I had explained to he Dr I was doing a litre of Delmont orange and day, a punnet of grapes a day, as well as a banana followed by the excesses of Christmas (I effectively induced Type 2 over the Christmas period as I was fine (maybe pre-diabetic) in the November with no diabetic symptoms; but during December I went mad on carbs the aforementioned, massive bowls of Oats and home made white flour pancakes. I thought I was eating healthy, as I did not have sugar in my drinks, no fizzy drinks etc as a norm. This is not an argument I am having, just a point of view. As for the Eatwell Plate / Guide they can call it what they want,

 

[AloeSvea]

Yes. As pointed out, Metformin reduces the overall mortality risk for someone with diabetes, BEYOND pure bgl control.

In fact Metformin does very little towards dropping bgl levels, but does act to protect the heart and other vital organs by reducing insulin resistance.

Our condition needs more than just reducing the HbA1c to a magic number, You should look on the holistic approach for best protection.

Greetings @Oldvatr. Would it be a pain for you to find and link source/s for the fact that Metformin reduces overall mortality for T2D? (Or more likely - it's directing me somewhere in here you know about? )

I ask, because, and I am only bringing this up in here due to the thread subject-heading and topic - ie Dr Fung in particular on drugs, because I had the understanding that Dr Fung was very supportive of medications such as metformin, but does NOT say they actually lower mortality, but lowers severity of complications. Is my understanding.

I thought he said the opposite about mortality - that in actual fact due to ACCORD (and a list of about five other studies with big letters lol), no effect on actual too-early-death. His explanation of why drugs don't actually lower too-early death is because the blood glucose is still in the body, as is insulin. He has a great overstuffed balloon metaphor for the cell health and high insulin and high BG. The only way to lower too-early-death is by getting the BG out of the body in a way that will not help kill you (as drugs that do this apparently have a tendency to do - egads! And then get banned.). And lower your insulin levels to normal and healthy levels.

(He writes about it a lot in his blog Intensive Dietary Management).

This is where his fasting recommendations come in big time. Get the BG levels and even more importantly - in conjunction with insulin levels, as his premise is that it is the too high levels of insulin that will kill ya, by aiding the body to get it out, and down. Eg food-less periods. He advocates that over time your body is depleted of those dangerous fat stores around the organs/middle (ie the liver and pancreas) (and further up around the heart?), and ones normally-fluctuating glycogen stores in the liver get emptied regularly in food-less periods.

(I would like to add, that myself personally, at normal weight cannot use fasting for permanent weight loss. Anything I lose in a food-less period, the longest I have managed is 10 days, is regained upon eating - keto/LCHF - again. And I am not alone in this. For me food-less periods operate more as lower-end-of-normal weight maintenance, not losing the last resistant 10kg that probably stands between me and getting my blood glucose levels more normal.)

Please note - I would never normally bring up the too-early-death stuff, which is after all what we all fear and do not want (or this is my assumption) and is at the basis of why chronic illness diagnoses are so shocking as they are, as it is too 'in your face'. But this is the at the core of this thread discussion. And please note I recognise metformin is clearly a marvellous drug. (As does Dr Fung!)

And also, even though I like Dr Fung's explanation of T2D more than any other, I do totally recognise that it is just a theory. As they all are right now. (Which is quite something!) (As in not good all this stuff explaining the causes and treatments are still theories.)

 

[Oldvatr]

Greetings @Oldvatr. Would it be a pain for you to find and link source/s for the fact that Metformin reduces overall mortality for T2D? (Or more likely - it's directing me somewhere in here you know about? )

I ask, because, and I am only bringing this up in here due to the thread subject-heading and topic - ie Dr Fung in particular on drugs, because I had the understanding that Dr Fung was very supportive of medications such as metformin, but does NOT say they actually lower mortality, but lowers severity of complications. Is my understanding.

I thought he said the opposite about mortality - that in actual fact due to ACCORD (and a list of about five other studies with big letters lol), no effect on actual too-early-death. His explanation of why drugs don't actually lower too-early death is because the blood glucose is still in the body, as is insulin. He has a great overstuffed balloon metaphor for the cell health and high insulin and high BG. The only way to lower too-early-death is by getting the BG out of the body in a way that will not help kill you (as drugs that do this apparently have a tendency to do - egads! And then get banned.). And lower your insulin levels to normal and healthy levels.

(He writes about it a lot in his blog Intensive Dietary Management).

This is where his fasting recommendations come in big time. Get the BG levels and even more importantly - in conjunction with insulin levels, as his premise is that it is the too high levels of insulin that will kill ya, by aiding the body to get it out, and down. Eg food-less periods. He advocates that over time your body is depleted of those dangerous fat stores around the organs/middle (ie the liver and pancreas) (and further up around the heart?), and ones normally-fluctuating glycogen stores in the liver get emptied regularly in food-less periods.

(I would like to add, that myself personally, at normal weight cannot use fasting for permanent weight loss. Anything I lose in a food-less period, the longest I have managed is 10 days, is regained upon eating - keto/LCHF - again. And I am not alone in this. For me food-less periods operate more as lower-end-of-normal weight maintenance, not losing the last resistant 10kg that probably stands between me and getting my blood glucose levels more normal.)

Please note - I would never normally bring up the too-early-death stuff, which is after all what we all fear and do not want (or this is my assumption) and is at the basis of why chronic illness diagnoses are so shocking as they are, as it is too 'in your face'. But this is the at the core of this thread discussion. And please note I recognise metformin is clearly a marvellous drug. (As does Dr Fung!)

And also, even though I like Dr Fung's explanation of T2D more than any other, I do totally recognise that it is just a theory. As they all are right now. (Which is quite something!) (As in not good all this stuff explaining the causes and treatments are still theories.)

http://www.medscape.com/viewarticle/724468

http://care.diabetesjournals.org/content/25/12/2244

http://www.lifeextension.com/magazine/2001/9/report_metformin/Page-01

https://www.ncbi.nlm.nih.gov/pubmed/21205121/

There are more articles covering this topic in Dr Google

 

[AloeSvea]

Many thanks, @Oldvatr.