I kinda lost control this Xmas

[Oldvatr]

I think it will be interesting to see the eventual outcome of the NHS pilot low-cal diet programme based on the shakes. This is certainly targeted on gaining remission-proper (i.e. normalisation of the metabolism) rather than just good control or “suppression”. I am not optimistic, as I think the programme is much too severe for most people, I think there’ll be a lot of compliance failure. And I don’t think such a radical method for the requisite weight loss is necessary anyway. Well, we will see. But I also think that a fair proportion of those who do stay the course will achieve remission-proper, so be able to enjoy all those mince pies and xmas pud without significant bg problems. But again, we will see. I would wish to see newcomers here at least made aware of the possibility of remission-proper through serious overt weigh loss, but they rarely are, being immediately steered instead only towards low-carb suppression. I fear this could cause opportunities to be lost. Still …

It seems the NHS is changing the definition of Remission to that adopted by Taylor for the ND which is simply an HbA1c below 48. It allows the continued use of medication to be included in the definition. Previous to Taylor et al, the definitiion was consecutive HbA1c below 42 with zero diabetes medication. Big difference.

Your comments regarding Low Carb seem to make the assertion that weight loss does not occur with carb control. Also you seem to refuse to recognise that the shakes based diet plan of ND is ALSO a low carb diet plan. It is the marketing that is different, and the removal of fat from the ND version. However, many of us here have used LCHF to reduce weight. I lost 8 stone on it, and my late (non diabetic) wife also lost 10 stone on it. Others have shared similar experience.

But the ND is only recommended for max 8 weeks (but the NHS is trying to stretch it to two stints of 10 weeks) whereas I have been doing LCHF for over 8 years now, I do not carb count and I do not calorie count (never have) Are you a counter?

 

[chrisjohnh]

It seems the NHS is changing the definition of Remission to that adopted by Taylor for the ND which is simply an HbA1c below 48. It allows the continued use of medication to be included in the definition. Previous to Taylor et al, the definitiion was consecutive HbA1c below 42 with zero diabetes medication. Big difference.

Your comments regarding Low Carb seem to make the assertion that weight loss does not occur with carb control. Also you seem to refuse to recognise that the shakes based diet plan of ND is ALSO a low carb diet plan. It is the marketing that is different, and the removal of fat from the ND version. However, many of us here have used LCHF to reduce weight. I lost 8 stone on it, and my late (non diabetic) wife also lost 10 stone on it. Others have shared similar experience.

But the ND is only recommended for max 8 weeks (but the NHS is trying to stretch it to two stints of 10 weeks) whereas I have been doing LCHF for over 8 years now, I do not carb count and I do not calorie count (never have) Are you a counter?

I absolutely agree that 48 is a poor choice of threshold. And of course I acknowledge that reducing carbs can play a major role in weight loss, although I think that in most cases that is mainly because it encourages an overall cals deficit but I recognise that is not the whole story. Yes, the shakes are indeed low carb, in fact low everything. But the suggestion sometimes seen that the shakes reduce weight not by their low cals but by their low carbs was described to me by Taylor and Lean as “mistaken and facile”. Yes, I did do a lot of counting at first but am weaning myself off that as I get better intuition. The absolute priority for me was rapid and substantial weight loss followed by two years of ruthless weight stability, plus a great deal of finger pricking. I truly do not know whether the weight loss was actually necessary for me. Do we see many cases where people have pulled A1c down from, say, 75 to 35 wholly by low carb but with no weight loss? (so, keeping their weight unaltered by eating tons of fat and protein along with their low carbs) If so, that would be game-changing proof that the Newcastle strategy had been entirely misguided from the start. It’s all very unsettled at present, but I do think that newcomers should at least be alerted that there has been some science done on trying to achieve true normalisation, albeit we may pick holes in it, so that they can get an idea of the options.

 

[chrisjohnh]

Weight loss doesn’t always equal remission - to date I’ve now lost over 11st, keeping most of that off for 12 years- no remission for me I’m afraid. The ONLY thing that keeps my numbers acceptable without meds is keto with minimal dairy and calorie counting to keep my weight down. I don’t agree that weight loss equals remission and I think to simplify it like that gives false hope to the newly diagnosed

No one has claimed that weight loss would “always” equal remission, it has long been recognized that it works only for some, and possible reasons have been put forward for that. But because it is not an “always” thing does not mean it should be hidden from newcomers. That would be like hiding antibiotics because they were not “always” effective.

 

[lovinglife]

No one has claimed that weight loss would “always” equal remission, it has long been recognized that it works only for some, and possible reasons have been put forward for that. But because it is not an “always” thing does not mean it should be hidden from newcomers. That would be like hiding antibiotics because they were not “always” effective.

But you said “a fair few” which Isn’t what I see. I see very very few in true remission i.e.) being able to go back to eating anything and everything without affect on BS. If remission means non diabetic numbers whilst continuing the new lifestyle, then yes, there is a fair few of those.

When you say hidden from new comers - do you mean in general or particular to this forum?

 

[Oldvatr]

I absolutely agree that 48 is a poor choice of threshold. And of course I acknowledge that reducing carbs can play a major role in weight loss, although I think that in most cases that is mainly because it encourages an overall cals deficit but I recognise that is not the whole story. Yes, the shakes are indeed low carb, in fact low everything. But the suggestion sometimes seen that the shakes reduce weight not by their low cals but by their low carbs was described to me by Taylor and Lean as “mistaken and facile”. Yes, I did do a lot of counting at first but am weaning myself off that as I get better intuition. The absolute priority for me was rapid and substantial weight loss followed by two years of ruthless weight stability, plus a great deal of finger pricking. I truly do not know whether the weight loss was actually necessary for me. Do we see many cases where people have pulled A1c down from, say, 75 to 35 wholly by low carb but with no weight loss? (so, keeping their weight unaltered by eating tons of fat and protein along with their low carbs) If so, that would be game-changing proof that the Newcastle strategy had been entirely misguided from the start. It’s all very unsettled at present, but I do think that newcomers should at least be alerted that there has been some science done on trying to achieve true normalisation, albeit we may pick holes in it, so that they can get an idea of the options.

There is nothing magical about the ND diet. It is a bog standard weight loss regime that has been in common use since the 60's in the form of Slimfast (and Optifast), and these diets are still going strong. Neither of these plans were associated with diabetes and were not generally a goto for diabetes treatment. The glucose reduction is noted as a 'can reduce' in the literature, but no claims for remission were made till ND was published with the altered definition and free use of the term. The claims for remission are peculiar to ND followers but are unproven as being a long term solution for Type 2 diabetes.

The only thing that Taylor did prove was an association between pancreatic fat and the treatment using the MRI scanner. He also attempted to to show first phase insulin response recovery, but his methodology and mathematics are extremely suspect for this aspect, and I do not accept his explanations.

I do not pooh pooh the valuable contribution he has made to diabetes treatment, since what he offers is a useful tool but it is not a cure. And there are other pathways to achieving remission (as he defines it). I have not exceeded the 48 HbA1c in 7 years now, and I did not do the ND plan. But I am happy for others to try it so long as they are given the information to make an informed choice regarding the long term success rate, which seems to require two or more passes through the mincer,

 

[KennyA]

I came out relatively unscathed, with the new information that tiramisu is relatively safe for me. Of course the valpolicella and grappa that preceded and followed it might have had something to do with that. Plenty of lamb and turkey and dairy as usual, half a roast potato, mashed swede instead of mashed potato....and the Salute zero sugar beer which is a blessing.

I ran out of test strips before new year, but I had no reading above 6 so quite happy.

 

[Resurgam]

As I went back into normal blood glucose numbers quite quickly after going low carb from diagnosis, and had Hba1c of 47 at 80 days, the weightloss was not the reason for it, rather the revers appears to be the case, going back to normal levels resulted in the weightloss, which is, so I am told 70lb from the heaviest recorded by the surgery.

 

[KennyA]

As I went back into normal blood glucose numbers quite quickly after going low carb from diagnosis, and had Hba1c of 47 at 80 days, the weightloss was not the reason for it, rather the revers appears to be the case, going back to normal levels resulted in the weightloss, which is, so I am told 70lb from the heaviest recorded by the surgery.

Yes - me too. I wasn't ever that high but dropped from 50 to 36 in four months. The >25kg weight loss I've had in the last three years followed, not preceded, decent BG control.

 

[Oldvatr]

Yes - me too. I wasn't ever that high but dropped from 50 to 36 in four months. The >25kg weight loss I've had in the last three years followed, not preceded, decent BG control.

Moi aussi. Me too (no, not That one) My return to normal sugars preceded my weightloss. I went from 106 to 52 HbA1c in my first 3 months of LCHF, and that was because I was aiming for a soft landing, and not pushing it. gently, gently catchee monkey.

 

[Oldvatr]

No one has claimed that weight loss would “always” equal remission, it has long been recognized that it works only for some, and possible reasons have been put forward for that. But because it is not an “always” thing does not mean it should be hidden from newcomers. That would be like hiding antibiotics because they were not “always” effective.

One of these days I will repeat my deep dive into the testimonials sub thread and try to extrapolate how many were achieving success by the two different methods. The last time I looked there were a couple of ND style dieters, but the majority were LCHF or keto. There were some Mediterranean ones too.

The other lot (DUK) push the Eatwell plate and ND but declare LCHF as dangerous and non effective. I was expelled from their forum for sharing my LCHF results on it. So who is it that is restricting choice? Many of the Mods here are or were ND users, but looking at their journey most seem to have moved over to a Low carb diet woe. That to me makes sense: that LCHF makes a good maintenance plan after ND. Eatwell does not.

The other lot are the main source of funding for ND, so that may explain why they support it so strongly. This site runs NHS approved online courses for LCHF so that too brings in a certain bias. But I have not seen anyone here suppress ND. We just nit pick the holes in it since it is not written on tablets of stone, and Newcastle is not on top of a mountain as far as I am aware. I am just sensitive to hype and marketing ploys. Sadly ND seems to suffer from these. Its just a diet in the classical sense.

 

[Lainie71]

I was good and just tutted my way through the other half eating what the hell he could He then complained he had put on a few pounds! I am just finding it difficult to kick start the exercise again. Have only worked out once in the last 2 weeks!

 

[chrisjohnh]

I think the above three cases of low carbs having pulled A1c right down in a short time, well before a big drop in weight, are very interesting. In my own case I did not give myself the opportunity to test that as I forced my weight down quickly from the start whilst going low carb at the same time. If I knew now that the weight loss had been unnecessary I would regret having done it, as I really am pretty skinny.
Today I re-read Dr Unwin’s excellent BMJ paper on his own surgery experiment in which he monitored his low-carb T2 patients for nearly three years. About half of them got down to A1c of 48 or below, but he states that all of them underwent weight loss. He is very clear in his view that weight loss is the aim and low carbs a tactic for that, as opposed to low carbs being the aim and leaving weight loss as only a possibility. But his view is also perhaps belied by the above cases. As I said earlier, the relative importance of these factors is not yet settled.
On the DUK theme, my impression is that they have become more receptive to LCHF and very many of their forum members now are strong low carb advocates (and not being expelled!).

 

[Oldvatr]

I think the above three cases of low carbs having pulled A1c right down in a short time, well before a big drop in weight, are very interesting. In my own case I did not give myself the opportunity to test that as I forced my weight down quickly from the start whilst going low carb at the same time. If I knew now that the weight loss had been unnecessary I would regret having done it, as I really am pretty skinny.
Today I re-read Dr Unwin’s excellent BMJ paper on his own surgery experiment in which he monitored his low-carb T2 patients for nearly three years. About half of them got down to A1c of 48 or below, but he states that all of them underwent weight loss. He is very clear in his view that weight loss is the aim and low carbs a tactic for that, as opposed to low carbs being the aim and leaving weight loss as only a possibility. But his view is also perhaps belied by the above cases. As I said earlier, the relative importance of these factors is not yet settled.
On the DUK theme, my impression is that they have become more receptive to LCHF and very many of their forum members now are strong low carb advocates (and not being expelled!).

Weight loss is inherent to Low Carb diets because the initial loss is of glycogen from the liver and muscle tissue. Now glycogen is made up of one glucose and three water molecules, so losing glycogen will automatically release water. This effect is well observed when crash dieting. The losing of adipose fat through neoglucogenesis takes a lot longer which is why the spare tyres and love handles are so difficult to shift This is an aspect of the ND study that I have diffficulty with, I am surprised at how quickly the pancreatic fat was dissolved and used up in the 8 weeks of the trial. That fat is fat that is in the wrong place, and does not normally respond to natural treatments (aka NAFLD). So there is either magic or miracles being performed by a simple classic diet which has not previously been noted for curing NAFLD or Diabetes. Has anyone seen the MRI scan results? Apart from the textual description given by Roy Taylor? They had to create some special software for this discovery - has this software been reviewed independently? Has anyone else used the software since? Why is this diet not being touted by the NHS for treating NAFLD? There are many conundrums that Roy Taylor is happy to explain, but something in my mind is uneasy.

 

[chrisjohnh]

Weight loss is inherent to Low Carb diets because the initial loss is of glycogen from the liver and muscle tissue. Now glycogen is made up of one glucose and three water molecules, so losing glycogen will automatically release water. This effect is well observed when crash dieting. The losing of adipose fat through neoglucogenesis takes a lot longer which is why the spare tyres and love handles are so difficult to shift This is an aspect of the ND study that I have diffficulty with, I am surprised at how quickly the pancreatic fat was dissolved and used up in the 8 weeks of the trial. That fat is fat that is in the wrong place, and does not normally respond to natural treatments (aka NAFLD). So there is either magic or miracles being performed by a simple classic diet which has not previously been noted for curing NAFLD or Diabetes. Has anyone seen the MRI scan results? Apart from the textual description given by Roy Taylor? They had to create some special software for this discovery - has this software been reviewed independently? Has anyone else used the software since? Why is this diet not being touted by the NHS for treating NAFLD? There are many conundrums that Roy Taylor is happy to explain, but something in my mind is uneasy.

I have seen a presentation by him in which he displayed the original pancreas and liver MRI scans. I was more struck by his description of pre-remission pancreases as unnaturally shrivelled and distorted, but after a year had plumped up to twice the size and with normal shape restored. Not that this tells us anything definite about their functioning.

 

[Oldvatr]

As a coda, i seem to have restored my pancreatic output to its normal conditions.

I am using a set meal to investigate. It is beefsteak with potatoes and beans.
on the way I discovered a valuable lesson - Fava beans are bad news for me.

Results Pre / 2hr / 4hr glucose

Meal #1: with fava beans = 7.4/ 6.3 / 6.3
Meal #2: with runner beans= 5.4/ 5.3/ 3.7
Meal #3: with runner beans = 6.6 /6.2 /3.7

So, yes, I did have some mild hypo symptoms due to the gliclazide, but nothing to worry about. But I'm back !!!!! Shame - I am gonna miss my fava beans (in England, they are Broad Beans), I had thought that being above ground veg they would be ok , WRONG!

 

[chrisjohnh]

As a coda, i seem to have restored my pancreatic output to its normal conditions.

I am using a set meal to investigate. It is beefsteak with potatoes and beans.
on the way I discovered a valuable lesson - Fava beans are bad news for me.

Results Pre / 2hr / 4hr glucose

Meal #1: with fava beans = 7.4/ 6.3 / 6.3
Meal #2: with runner beans= 5.4/ 5.3/ 3.7
Meal #3: with runner beans = 6.6 /6.2 /3.7

So, yes, I did have some mild hypo symptoms due to the gliclazide, but nothing to worry about. But I'm back !!!!! Shame - I am gonna miss my fava beans (in England, they are Broad Beans), I had thought that being above ground veg they would be ok , WRONG!

Great pancreas!

 

[Oldvatr]

Great pancreas!

Indeed. It is one of the few bits of my body that is appearing to function properly. However, I do get a strong reaction to carbs that shows I have still got some Insulin Resistance ( i.e. the drop in bgl is a basal not bolus effect) However, having said that, it is not unusual for me to see a lower 2hr PP than the pre reading when low carbing. I seem to be programmed to raise my bgl during the day or it is a very slow response to my breakfast (I would say fried English breakfast but it is usually incinerated)

 

[AloeSvea]

I've dealt with the traditional-Christmas-food dilemma for those of us treating T2D and Diabetes generally with diet, by taking time off of a restricted diet at that time. How much time depends on the social environment - as Oldvatr discussed so well in his own Christmas home life.

I love Christmas, and traditional English and Kiwi Christmas food. I can't bear the idea of not having it. I admire those folks in here who can keep up the LCHF and Keto in the face of Xmas trifle, but there you are.

But does it affect my metabolism and my moods? sadly, oh yes! I typically lose it, as in my temper, at least once every Christmas, as I clearly don't have the ability to find my sweets sweet point. I'm like a bad drunk with sugar. I seem to always be in the kitchen working hard and clearly exhausted. Which after a few days of fruit-mince pies, pavlova, and the like, and I am sure with my raging blood glucose levels - there I am.

I love the non-covid proper Christmas being back, but I don't like the workload. I even asked my adult child to help me out in the kitchen and with caregiving the two family members who badly need it this year - she got a shock as I usually see it as a holiday from such for her when she is at mine. Nowadays I tell her constantly that I am looking forward to the day I am the guest at Xmases she hosts. She looked horrified, lol.

My poor ol' fasting blood glucose level has been having a tough time since. Custard and pav and so on will do that? Oh yes! It's my first Xmas being medicated, and no difference to a sugar onslaught I would say. I would need a shot or two of insulin to do that....wonder what Dr Fung would say about that? me with severe insulin resistance, and probably damaged cells and apparently - genes, for Africa. He would be right. But am I going to eat Xmas food next year? Well -yes! Keeping it to just one day seems just too hard. So - Xmas food for three to four days. No control to lose!