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Is glucose central to the three great epidemics; obesity, diabetes, and non-alcoholic fatty liver?

Southport GP

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Location
Merseyside
Type of diabetes
HCP
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I do not have diabetes
I wonder if glucose is central to the three great epidemics of our time; obesity, diabetes, and non-alcoholic fatty liver (20% of the population)

With The Department of Obesity and Endocrinology, Liverpool University and Prof Feinman of New York we have researched a practical response to try and help some of the folk with abnormal liver function, many of whom have T2D by using a lower carb, higher fat diet; published here http://bit.ly/1NYsS6x

The work has taken three years and was nearly fully funded by us in the practice. Please pass it on if you feel it has any merit.

Essentially when the liver glucose stores are full any more dietary glucose has to be cleared somehow-so the liver converts it to fat – fatty liver. Prof Taylor feels this fat and similar fat in the pancreas explains why (I love this quote.)

‘Before diagnosis of Type 2 diabetes, there is a long silent scream from the liver.

As the fat interferes with the normal functioning of both organs.

The good news is this process could be reversible and may possibly in part help explain how reducing the glucose in the diet can improve liver function, insulin sensitivity and obesity.

Certainly the patients in the study had the GGT liver blood test improve by an average of 47%. Reading this it looks a huge claim- makes me nervous. Anyway read the paper for more, but bear in mind I am not an academic only a GP and it’s just a pilot study.

Thanks to my wife Jen I can now be followed on twitter @lowcarbGP
 
@southportgp, have you read the Credit Suisse research on Fat?
 
I feel happy for both you and your patients. So cool that you are following this line of reasearch and good luck in your further endevaours!
 
In the RH corner, we use our glucose to quickly and the excess insulin creates the visceral fat.
However, not haven't read the report yet, that glucose is harmful to us because it upsets the balance of our response to digesting it.
In sports, having talked to a nutritionist, glucose is only given or taken after as a restorative, not for energy during. Where water is recommended.
 
Roytaylorjasonfunglover said:
I feel happy for both you and your patients. So cool that you are following this line of reasearch and good luck in your further endevaours!
Click to expand...
I am trying to get it out there that the LCHF diet it a perfectly good choice for many. Also offering it has brought our diabetes drug budget down reduced obesity and improved diabetic care . The recent greater safety for saturated fats evidence is helping too
 

Off topic, I know, but have you seen this, published in GP Online today?:

http://www.gponline.com/gps-patients-choose-when-ignore-nice-advice-says-haslam/article/1368070

So, we're now only doing as we're told.
 
Hi Southport GP,
If like me one has a bmi of 24 and type2 controlled at 45 there is really no alternative to a low carb diet when a high GGT and Reactive Hypoglycemia is added to the mix.
I shall just have to put up with being a scraggy old man!
Good work you are doing.
regards
Derek
 
I have a few questions regarding this study. Does excess glucose in the blood automatically cause fat to build up in the liver? In other words, is it possible to be insulin resistant but still have normal liver function? Likewise, can a lean individual who has very little excess body fat(no more than 5 lbs) be insulin resistant with high glucose levels? Also, is there a correlation between the GGT enzyme and AST/ALT enzymes? Meaning, can an individual have normal levels of AST and ALT enzymes but abnormal GGT levels?
 
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Hi Forecaster,
Its happened to me my GGT peaked at c.140 and the other liver readings were OK. I thought it was warfarin doing it but I reckon it is high G.I. carbs. It will be interesting to see what Southport GP says.
D.
 
I low carbed for two, nearly three years, before I switched to organic and wild. I had been diagnosed anaemia and switched in between blood tests. Not only did the anaemia disappear after only 2 weeks on organic, but my liver function test normalised as well.

I disregard the anaemia thing because blood tests are like snapshots of the blood in a way. But the liver could be more significant. It was shown on a Scandinavian documentary, that going organic for a month, got rid of almost all pesticides from the blood and these are ultimately dealt with by the liver. My assumption is therefore, that by reducing the work my liver had to do, it was better able to cope.

I take the view that it's my job, to give my body the best nutrition I can and trust it to make use of it. Low carb didn't stop me getting maculopathy but eating organic food helped heal it up. If I hadn't seen the photos, I wouldn't have believed it to be possible.

My ophthalmologist believes that if we help our body, it will help us right back and told me to keep doing what I'm doing.
 
Great work @Southport GP .I was a Southport lady till my late 30's.

Isn't this what Dr Jason Fung found ? That once the "cup of glucose" is full we need a way to drain that cup and the liver steps in.The good news is that he found his patients lost the fatty liver first with relatively little weight losses .
 
Does excess glucose in the blood automatically cause fat to build up in the liver? - A.Not always but often does in my experience, exercise helps too.
Is it possible to be insulin resistant but still have normal liver function-A. yes some folk do
Can a lean individual who has very little excess body fat(no more than 5 lbs) be insulin resistant with high glucose levels? A.Probably but I haven't met many.
Is there a correlation between the GGT enzyme and AST/ALT enzymes? A.Yes often Meaning, can an individual have normal levels of AST and ALT enzymes but abnormal GGT levels A. yes

Another thing; rarely you can have normal liver function blood tests but a scan can show fatty liver, but again I haven't seen many of these. Even so I still think a raised GGT blood test is a significant finding and most of the study group had great improvements in their GGT results along with weight loss and improved diabetic control
 
Ok thanks.
I know that there are a lot of tests that can be used that are related to insulin resistance, but do you think a diagnosis can be made based on certain mixed results? For instance, if someone has normal fasting blood sugar, a good triglyceride/HDL cholesterol ratio, normal liver tests, no excess body fat, but a high A1C, could it be that this person just happens to be at a very early stage of insulin resistance? Or would you say it's also possible that this person's glucose control is good and some other factor (such as genetics) is causing the A1C reading to be high?
 
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If you have normal LPT, normal liver US, normal weight, low BP, negative GAD and ICA, are 50 years, have positive OGTT at 14 but can keep BG below 7 on LCHF, do you have insulin resistance?

Q for @Southport GP
 
tim2000s said:
@southportgp, have you read the Credit Suisse research on Fat?
Click to expand...
Yes I have Zoe Harcombe sent it to me. I thought it was a good piece of work.
The financial world is convinced about the money to be made from healthy fats and knows that sugar and refined carbs have had their best money making days!
Cheers
 
The trick is knowing when to move the money though.
I must admit, I have shifted the odd pound from oil, into buffalo milk as ghee seems to be the new thing.
(and yes, you can buy futures in buffalo milk, if you want a gamble here and there)
 
Hi,
I hear that a hospital consultant (gastroenterologist) in the South Lancs area has told GP's not to do GGT blood tests! Other liver blood tests can be done as normal.

With the current epidemic of liver disease and diabetes this is a retrograde step and perhaps one would find it difficult to comprehend.

I understand GGT is a relatively low cost blood test so that cannot be the reason.

I hope this is not a national policy.
regards
D.
 
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